401k Plan data: STACY FURNITURE 401(K) PLAN plan

STACY FURNITURE 401(K) PLAN 401k Plan overview

Plan Name	STACY FURNITURE 401(K) PLAN
Plan identification number	001

STACY FURNITURE 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

STACY FAMILY ENTERPRISES, INC. has sponsored the creation of one or more 401k plans.

Company Name: STACY FAMILY ENTERPRISES, INC.

Employer identification number (EIN): 752360470

NAIC Classification: 442110
NAIC Description: Furniture Stores

Additional information about STACY FAMILY ENTERPRISES, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1991-01-09

Company Identification Number: 0117873300

Legal Registered Office Address: 1900 S MAIN ST STE 200

GRAPEVINE
United States of America (USA)
76051

More information about STACY FAMILY ENTERPRISES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STACY FURNITURE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01 JEFFREY PETERSON 2022-08-29
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 WILLIAM CHERRY
001 2013-01-01 WILLIAM CHERRY
001 2012-01-01 WILLIAM CHERRY 2013-09-30
001 2011-01-01 WILLIAM T. CHERRY III 2012-10-15
001 2010-01-01 BILL CHERRY BILL CHERRY 2011-09-12
001 2009-01-01 WILLIAM T. CHERRY, III WILLIAM T. CHERRY, III 2010-10-05

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01	JEFFREY PETERSON	2022-08-29
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	WILLIAM CHERRY
001	2013-01-01	WILLIAM CHERRY
001	2012-01-01	WILLIAM CHERRY	2013-09-30
001	2011-01-01	WILLIAM T. CHERRY III	2012-10-15
001	2010-01-01	BILL CHERRY		BILL CHERRY	2011-09-12
001	2009-01-01	WILLIAM T. CHERRY, III		WILLIAM T. CHERRY, III	2010-10-05

Plan Statistics for STACY FURNITURE 401(K) PLAN

401k plan membership statisitcs for STACY FURNITURE 401(K) PLAN

Measure Date Value
2022: STACY FURNITURE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 79
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 73
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 6
Total of all active and inactive participants 2022-01-01 79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 79
Number of participants with account balances 2022-01-01 41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2020: STACY FURNITURE 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 71
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 13
Total of all active and inactive participants 2020-01-01 84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 84
Number of participants with account balances 2020-01-01 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: STACY FURNITURE 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 101
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 86
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 13
Total of all active and inactive participants 2019-01-01 99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 99
Number of participants with account balances 2019-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: STACY FURNITURE 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 84
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 13
Total of all active and inactive participants 2018-01-01 97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 97
Number of participants with account balances 2018-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: STACY FURNITURE 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 96
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 11
Total of all active and inactive participants 2017-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 107
Number of participants with account balances 2017-01-01 53
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: STACY FURNITURE 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 93
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 15
Total of all active and inactive participants 2016-01-01 108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 108
Number of participants with account balances 2016-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: STACY FURNITURE 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 128
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 13
Total of all active and inactive participants 2015-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 141
Number of participants with account balances 2015-01-01 57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: STACY FURNITURE 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 107
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 12
Total of all active and inactive participants 2014-01-01 119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 119
Number of participants with account balances 2014-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: STACY FURNITURE 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 151
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 5
Total of all active and inactive participants 2013-01-01 156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 156
Number of participants with account balances 2013-01-01 63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2010: STACY FURNITURE 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 106
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 3
Total of all active and inactive participants 2010-01-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 109
Number of participants with account balances 2010-01-01 63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 17
2009: STACY FURNITURE 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 136
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 16
Total of all active and inactive participants 2009-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 152
Number of participants with account balances 2009-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 15

Measure	Date	Value
2022: STACY FURNITURE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	79
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	73
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	6
Total of all active and inactive participants	2022-01-01	79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	79
Number of participants with account balances	2022-01-01	41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2020: STACY FURNITURE 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	71
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	13
Total of all active and inactive participants	2020-01-01	84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	84
Number of participants with account balances	2020-01-01	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: STACY FURNITURE 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	101
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	86
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	13
Total of all active and inactive participants	2019-01-01	99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	99
Number of participants with account balances	2019-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: STACY FURNITURE 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	84
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	13
Total of all active and inactive participants	2018-01-01	97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	97
Number of participants with account balances	2018-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: STACY FURNITURE 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	96
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	11
Total of all active and inactive participants	2017-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	107
Number of participants with account balances	2017-01-01	53
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: STACY FURNITURE 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	93
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	15
Total of all active and inactive participants	2016-01-01	108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	108
Number of participants with account balances	2016-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: STACY FURNITURE 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	128
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	13
Total of all active and inactive participants	2015-01-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	141
Number of participants with account balances	2015-01-01	57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: STACY FURNITURE 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	107
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	12
Total of all active and inactive participants	2014-01-01	119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	119
Number of participants with account balances	2014-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: STACY FURNITURE 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	151
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	5
Total of all active and inactive participants	2013-01-01	156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	156
Number of participants with account balances	2013-01-01	63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2010: STACY FURNITURE 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	106
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	3
Total of all active and inactive participants	2010-01-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	109
Number of participants with account balances	2010-01-01	63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	17
2009: STACY FURNITURE 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	136
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	16
Total of all active and inactive participants	2009-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	152
Number of participants with account balances	2009-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	15

Financial Data on STACY FURNITURE 401(K) PLAN

Measure	Date	Value
2022 : STACY FURNITURE 401(K) PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$0
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-251,423
Expenses. Total of all expenses incurred	2022-12-31	$350,730
Benefits paid (including direct rollovers)	2022-12-31	$338,333
Total plan assets at end of year	2022-12-31	$2,082,238
Total plan assets at beginning of year	2022-12-31	$2,684,391
Value of fidelity bond covering the plan	2022-12-31	$500,000
Total contributions received or receivable from participants	2022-12-31	$129,819
Expenses. Other expenses not covered elsewhere	2022-12-31	$0
Contributions received from other sources (not participants or employers)	2022-12-31	$4,667
Other income received	2022-12-31	$-400,263
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-602,153
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$2,082,238
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$2,684,391
Assets. Value of participant loans	2022-12-31	$39,191
Total contributions received or receivable from employer(s)	2022-12-31	$14,354
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$12,397
2020 : STACY FURNITURE 401(K) PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$554,288
Total of all expenses incurred	2020-12-31	$630,840
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$608,201
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$146,312
Value of total assets at end of year	2020-12-31	$3,265,632
Value of total assets at beginning of year	2020-12-31	$3,342,184
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$22,639
Total interest from all sources	2020-12-31	$5,358
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$115,377
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$115,377
Administrative expenses professional fees incurred	2020-12-31	$22,639
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
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	$135,352
Participant contributions at end of year	2020-12-31	$83,394
Participant contributions at beginning of year	2020-12-31	$114,070
Participant contributions at end of year	2020-12-31	$8,577
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$5,576
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$-76,552
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,265,632
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,342,184
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 registered invesment companies (eg mutual funds) at end of year	2020-12-31	$3,170,369
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$3,217,767
Interest on participant loans	2020-12-31	$5,286
Interest earned on other investments	2020-12-31	$72
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$3,292
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$9,839
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$287,241
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	$5,384
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$508
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$608,201
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	PHILIP C. MAY PC
Accountancy firm EIN	2020-12-31	800794417
2019 : STACY FURNITURE 401(K) PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$797,399
Total income from all sources (including contributions)	2019-12-31	$797,399
Total of all expenses incurred	2019-12-31	$695,206
Total of all expenses incurred	2019-12-31	$695,206
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$667,096
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$667,096
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$158
Value of total corrective distributions	2019-12-31	$158
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$168,072
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$168,072
Value of total assets at end of year	2019-12-31	$3,342,184
Value of total assets at end of year	2019-12-31	$3,342,184
Value of total assets at beginning of year	2019-12-31	$3,239,991
Value of total assets at beginning of year	2019-12-31	$3,239,991
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$27,952
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$27,952
Total interest from all sources	2019-12-31	$5,956
Total interest from all sources	2019-12-31	$5,956
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$137,743
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$137,743
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$137,743
Administrative expenses professional fees incurred	2019-12-31	$27,952
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
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
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$150,910
Participant contributions at end of year	2019-12-31	$114,070
Participant contributions at beginning of year	2019-12-31	$125,158
Participant contributions at beginning of year	2019-12-31	$125,158
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
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	$102,193
Value of net income/loss	2019-12-31	$102,193
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,342,184
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,342,184
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,239,991
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,239,991
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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 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
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$3,217,767
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$3,217,767
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,093,275
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,093,275
Interest on participant loans	2019-12-31	$5,783
Interest on participant loans	2019-12-31	$5,783
Interest earned on other investments	2019-12-31	$173
Interest earned on other investments	2019-12-31	$173
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$9,839
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$21,558
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$21,558
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$485,628
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$485,628
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
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
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
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	$17,162
Contributions received in cash from employer	2019-12-31	$17,162
Employer contributions (assets) at end of year	2019-12-31	$508
Employer contributions (assets) at end of year	2019-12-31	$508
Employer contributions (assets) at beginning of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$667,096
Did the plan have assets held for investment	2019-12-31	Yes
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
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
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	PHILIP C. MAY PC
Accountancy firm name	2019-12-31	PHILIP C. MAY PC
Accountancy firm EIN	2019-12-31	800794417
2018 : STACY FURNITURE 401(K) PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$-85,574
Total of all expenses incurred	2018-12-31	$212,200
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$205,291
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$1,860
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$148,940
Value of total assets at end of year	2018-12-31	$3,239,991
Value of total assets at beginning of year	2018-12-31	$3,537,765
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$5,049
Total interest from all sources	2018-12-31	$5,898
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$345,697
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$345,697
Administrative expenses professional fees incurred	2018-12-31	$5,049
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
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	$148,940
Participant contributions at end of year	2018-12-31	$125,158
Participant contributions at beginning of year	2018-12-31	$121,290
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-297,774
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,239,991
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$3,537,765
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 registered invesment companies (eg mutual funds) at end of year	2018-12-31	$3,093,275
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$3,400,617
Interest on participant loans	2018-12-31	$5,698
Interest earned on other investments	2018-12-31	$200
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$21,558
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$15,858
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-586,109
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
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$205,291
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	PHILLIP C. MAY PC
Accountancy firm EIN	2018-12-31	800794417
2017 : STACY FURNITURE 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	$0
Total income from all sources (including contributions)	2017-12-31	$565,957
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$100,742
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$91,413
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$130,850
Value of total assets at end of year	2017-12-31	$3,537,765
Value of total assets at beginning of year	2017-12-31	$3,072,550
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$9,329
Total interest from all sources	2017-12-31	$5,745
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$219,191
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$219,191
Administrative expenses professional fees incurred	2017-12-31	$9,329
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$400,000
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	$130,850
Participant contributions at end of year	2017-12-31	$121,290
Participant contributions at beginning of year	2017-12-31	$127,586
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2017-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$465,215
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,537,765
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,072,550
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 registered invesment companies (eg mutual funds) at end of year	2017-12-31	$3,400,617
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,930,199
Interest on participant loans	2017-12-31	$5,552
Interest earned on other investments	2017-12-31	$193
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$15,858
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$14,765
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$210,171
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
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$91,413
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	PHILLIP C MAY PC
Accountancy firm EIN	2017-12-31	800794417
2016 : STACY FURNITURE 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$408,364
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$70,290
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$84,505
Expenses. Certain deemed distributions of participant loans	2016-12-31	$-23,017
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$160,158
Value of total assets at end of year	2016-12-31	$3,072,550
Value of total assets at beginning of year	2016-12-31	$2,734,476
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$8,802
Total interest from all sources	2016-12-31	$5,050
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
Administrative expenses professional fees incurred	2016-12-31	$8,802
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$300,000
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	$160,158
Participant contributions at end of year	2016-12-31	$127,586
Participant contributions at beginning of year	2016-12-31	$86,770
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$14,765
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$13,285
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$338,074
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,072,550
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,734,476
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
Interest on participant loans	2016-12-31	$5,050
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$2,930,199
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$2,634,421
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$243,156
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
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$84,505
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	R. C. NEAL, P.C.
Accountancy firm EIN	2016-12-31	752618521
2015 : STACY FURNITURE 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	$0
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	$144,262
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$262,828
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$231,032
Expenses. Certain deemed distributions of participant loans	2015-12-31	$23,017
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$157,839
Value of total assets at end of year	2015-12-31	$2,734,476
Value of total assets at beginning of year	2015-12-31	$2,853,042
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$8,779
Total interest from all sources	2015-12-31	$5,004
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	$8,779
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$300,000
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	$157,839
Participant contributions at end of year	2015-12-31	$86,770
Participant contributions at beginning of year	2015-12-31	$145,913
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$3,875
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$13,285
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$4,972
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-118,566
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,734,476
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,853,042
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
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$5,004
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$2,634,421
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$2,698,282
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-18,581
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
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$231,032
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	R. C. NEAL, P.C.
Accountancy firm EIN	2015-12-31	752618521
2014 : STACY FURNITURE 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	$331,269
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$122,050
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$110,790
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$151,675
Value of total assets at end of year	2014-12-31	$2,853,042
Value of total assets at beginning of year	2014-12-31	$2,643,823
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$11,260
Total interest from all sources	2014-12-31	$7,376
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	$300,000
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	$151,675
Participant contributions at end of year	2014-12-31	$145,913
Participant contributions at beginning of year	2014-12-31	$181,952
Participant contributions at end of year	2014-12-31	$3,875
Participant contributions at beginning of year	2014-12-31	$3,085
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$4,972
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$7,946
Total non interest bearing cash at end of year	2014-12-31	$0
Total non interest bearing cash at beginning of year	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$209,219
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$2,853,042
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$2,643,823
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
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$7,376
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$2,698,282
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,450,840
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$172,218
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
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$110,790
Contract administrator fees	2014-12-31	$11,260
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	R. C. NEAL, P.C.
Accountancy firm EIN	2014-12-31	752618521
2013 : STACY FURNITURE 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
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	$530,157
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$123,981
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$113,033
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$150,007
Value of total assets at end of year	2013-12-31	$2,643,823
Value of total assets at beginning of year	2013-12-31	$2,237,647
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$10,948
Total interest from all sources	2013-12-31	$7,492
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
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	$110,000
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	$150,007
Participant contributions at end of year	2013-12-31	$181,952
Participant contributions at beginning of year	2013-12-31	$163,562
Participant contributions at end of year	2013-12-31	$3,085
Participant contributions at beginning of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$7,946
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$22,214
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Other income not declared elsewhere	2013-12-31	$14
Total non interest bearing cash at end of year	2013-12-31	$0
Total non interest bearing cash at beginning of year	2013-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$406,176
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$2,643,823
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$2,237,647
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
Interest on participant loans	2013-12-31	$7,492
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,450,840
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,051,871
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$372,644
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
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$113,033
Contract administrator fees	2013-12-31	$10,948
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	R. C. NEAL, P.C.
Accountancy firm EIN	2013-12-31	752618521
2010 : STACY FURNITURE 401(K) PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets	2010-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$0
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$0
Total transfer of assets from this plan	2010-12-31	$0
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	$345,593
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$105,063
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$90,536
Expenses. Certain deemed distributions of participant loans	2010-12-31	$0
Value of total corrective distributions	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$135,153
Value of total assets at end of year	2010-12-31	$2,028,271
Value of total assets at beginning of year	2010-12-31	$1,787,741
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$14,527
Total income from rents	2010-12-31	$0
Total interest from all sources	2010-12-31	$4,042
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$0
Administrative expenses professional fees incurred	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$110,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Amount of non-exempt transactions with any party-in-interest	2010-12-31	$0
Contributions received from participants	2010-12-31	$133,730
Participant contributions at end of year	2010-12-31	$93,662
Participant contributions at beginning of year	2010-12-31	$71,276
Participant contributions at end of year	2010-12-31	$13,483
Participant contributions at beginning of year	2010-12-31	$13,500
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$1,423
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$4
Administrative expenses (other) incurred	2010-12-31	$0
Liabilities. Value of operating payables at beginning of year	2010-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$240,530
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,028,271
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,787,741
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2010-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2010-12-31	$0
Investment advisory and management fees	2010-12-31	$0
Value of interest in pooled separate accounts at end of year	2010-12-31	$1,921,126
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,702,965
Interest on participant loans	2010-12-31	$4,042
Income. Interest from loans (other than to participants)	2010-12-31	$0
Interest earned on other investments	2010-12-31	$0
Income. Interest from US Government securities	2010-12-31	$0
Income. Interest from corporate debt instruments	2010-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$206,394
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Net gain/loss from 103.12 investment entities	2010-12-31	$0
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	Yes
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	$0
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$0
Income. Dividends from preferred stock	2010-12-31	$0
Income. Dividends from common stock	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$90,536
Contract administrator fees	2010-12-31	$14,527
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$0
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
Aggregate proceeds on sale of assets	2010-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2010-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	R.C. NEAL, P.C.
Accountancy firm EIN	2010-12-31	752618521
2009 : STACY FURNITURE 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for STACY FURNITURE 401(K) PLAN

2022: STACY FURNITURE 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	No
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
2020: STACY FURNITURE 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: STACY FURNITURE 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: STACY FURNITURE 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: STACY FURNITURE 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: STACY FURNITURE 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: STACY FURNITURE 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: STACY FURNITURE 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: STACY FURNITURE 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
2010: STACY FURNITURE 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: STACY FURNITURE 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	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

33312201

Policy instance

Insurance contract or identification number	33312201
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
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 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?	Yes
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

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

Policy contract number

333122-01

Policy instance

Insurance contract or identification number	333122-01
Number of Individuals Covered	3
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

333122-01

Policy instance

Insurance contract or identification number	333122-01
Number of Individuals Covered	99
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

333122-01

Policy instance

Insurance contract or identification number	333122-01
Number of Individuals Covered	111
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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	1
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?	Yes
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

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

Policy contract number

333122-01

Policy instance

Insurance contract or identification number	333122-01
Number of Individuals Covered	141
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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

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

Policy contract number

333122-01

Policy instance

Insurance contract or identification number	333122-01
Number of Individuals Covered	119
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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

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

Policy contract number

333122-01

Policy instance

Insurance contract or identification number	333122-01
Number of Individuals Covered	156
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

800821

Policy instance

Insurance contract or identification number	800821
Number of Individuals Covered	109
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $5,215
Total amount of fees paid to insurance company	USD $31
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,719
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker name	JEFFERSON PILOT LIFE INS AGENCY OF

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Company Name:	STACY FAMILY ENTERPRISES, INC.
Employer identification number (EIN):	752360470
NAIC Classification:	442110
NAIC Description:	Furniture Stores

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1991-01-09
Company Identification Number:	0117873300
Legal Registered Office Address:	1900 S MAIN ST STE 200 GRAPEVINE United States of America (USA) 76051