401k Plan data: STINE ENTERPRISES EMPLOYEES' 401K PLAN plan

STINE ENTERPRISES EMPLOYEES' 401K PLAN 401k Plan overview

Plan Name	STINE ENTERPRISES EMPLOYEES' 401K PLAN
Plan identification number	001

STINE ENTERPRISES EMPLOYEES' 401K 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

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

Company Name: STINE ENTERPRISES, INC.

Employer identification number (EIN): 860501161

NAIC Classification: 722513
NAIC Description: Limited-Service Restaurants

Additional information about STINE ENTERPRISES, INC.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 1999-06-30

Company Identification Number: 601964389

Legal Registered Office Address: 17910 NE HOOPER WOLLAM RD

YACOLT
United States of America (USA)
98675

More information about STINE ENTERPRISES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STINE ENTERPRISES EMPLOYEES' 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01
001 2015-01-01
001 2014-01-01 SHARON KENNEDY, APA, QPA, QKA, ERPA 2015-10-15
001 2013-01-01 SHARON KENNEDY, APA, QPA, QKA, ERPA 2014-08-06
001 2012-01-01 SHARON KENNEDY, APA, QPA, QKA, ERPA 2013-09-26
001 2011-01-01 KAMI GREENHALGH STEPHEN STINE 2012-06-29
001 2010-01-01 KAMI GREENHALGH
001 2009-01-01 KAMI GREENHALGH

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01
001	2015-01-01
001	2014-01-01	SHARON KENNEDY, APA, QPA, QKA, ERPA	2015-10-15
001	2013-01-01	SHARON KENNEDY, APA, QPA, QKA, ERPA	2014-08-06
001	2012-01-01	SHARON KENNEDY, APA, QPA, QKA, ERPA	2013-09-26
001	2011-01-01	KAMI GREENHALGH		STEPHEN STINE	2012-06-29
001	2010-01-01	KAMI GREENHALGH
001	2009-01-01	KAMI GREENHALGH

Plan Statistics for STINE ENTERPRISES EMPLOYEES' 401K PLAN

401k plan membership statisitcs for STINE ENTERPRISES EMPLOYEES' 401K PLAN

Measure Date Value
2016: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 109
Number of retired or separated participants receiving benefits 2015-01-01 19
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 128
Number of participants with account balances 2015-01-01 27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2011: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 62
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 40
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 18
Total of all active and inactive participants 2011-01-01 58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 58
Number of participants with account balances 2011-01-01 34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 75
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 46
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 16
Total of all active and inactive participants 2010-01-01 62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 62
Number of participants with account balances 2010-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 2
2009: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 84
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 60
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 15
Total of all active and inactive participants 2009-01-01 75
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 75
Number of participants with account balances 2009-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 8

Measure	Date	Value
2016: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	109
Number of retired or separated participants receiving benefits	2015-01-01	19
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	128
Number of participants with account balances	2015-01-01	27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2011: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	62
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	40
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	18
Total of all active and inactive participants	2011-01-01	58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	58
Number of participants with account balances	2011-01-01	34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	75
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	46
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	16
Total of all active and inactive participants	2010-01-01	62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	62
Number of participants with account balances	2010-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	2
2009: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	84
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	60
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	15
Total of all active and inactive participants	2009-01-01	75
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	75
Number of participants with account balances	2009-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	8

Financial Data on STINE ENTERPRISES EMPLOYEES' 401K PLAN

Measure	Date	Value
2016 : STINE ENTERPRISES EMPLOYEES' 401K 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	$177
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	$19,460
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$295,282
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$287,834
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$11,181
Value of total assets at end of year	2016-12-31	$177
Value of total assets at beginning of year	2016-12-31	$275,822
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$7,448
Total interest from all sources	2016-12-31	$828
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	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$35,000
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	$11,181
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$24,424
Participant contributions at end of year	2016-12-31	$177
Participant contributions at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$177
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) 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	$-275,822
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$275,822
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$194,193
Interest on participant loans	2016-12-31	$828
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$57,205
Net investment gain/loss from pooled separate accounts	2016-12-31	$7,451
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	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$287,834
Contract administrator fees	2016-12-31	$7,448
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	Yes
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	HEIDENREICH & HEIDENREICH CPAS PLLC
Accountancy firm EIN	2016-12-31	800192212
2015 : STINE ENTERPRISES EMPLOYEES' 401K 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	$16,900
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$4,361
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$3,152
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$17,691
Value of total assets at end of year	2015-12-31	$275,822
Value of total assets at beginning of year	2015-12-31	$263,283
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,209
Total interest from all sources	2015-12-31	$909
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
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$35,000
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	$17,691
Participant contributions at end of year	2015-12-31	$24,424
Participant contributions at beginning of year	2015-12-31	$19,928
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	$12,539
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$275,822
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$263,283
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$194,193
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$183,931
Interest on participant loans	2015-12-31	$909
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$57,205
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$59,424
Net investment gain/loss from pooled separate accounts	2015-12-31	$-1,700
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	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$3,152
Contract administrator fees	2015-12-31	$1,209
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	HEIDENREICH & HEIDENREICH CPAS PLLC
Accountancy firm EIN	2015-12-31	800192212
2011 : STINE ENTERPRISES EMPLOYEES' 401K PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$31,690
Expenses. Total of all expenses incurred	2011-12-31	$58,318
Benefits paid (including direct rollovers)	2011-12-31	$56,478
Total plan assets at end of year	2011-12-31	$274,445
Total plan assets at beginning of year	2011-12-31	$301,073
Total contributions received or receivable from participants	2011-12-31	$33,670
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-1,980
Net income (gross income less expenses)	2011-12-31	$-26,628
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$274,445
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$301,073
Assets. Value of participant loans	2011-12-31	$29,167
Total contributions received or receivable from employer(s)	2011-12-31	$0
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$1,840
2010 : STINE ENTERPRISES EMPLOYEES' 401K PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$73,781
Expenses. Total of all expenses incurred	2010-12-31	$24,968
Benefits paid (including direct rollovers)	2010-12-31	$22,858
Total plan assets at end of year	2010-12-31	$301,073
Total plan assets at beginning of year	2010-12-31	$252,260
Total contributions received or receivable from participants	2010-12-31	$46,102
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$26,348
Net income (gross income less expenses)	2010-12-31	$48,813
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$301,073
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$252,260
Assets. Value of participant loans	2010-12-31	$33,383
Total contributions received or receivable from employer(s)	2010-12-31	$1,331
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$2,110

Form 5500 Responses for STINE ENTERPRISES EMPLOYEES' 401K PLAN

2016: STINE ENTERPRISES EMPLOYEES' 401K 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	Yes
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 - Trust	Yes
2015: STINE ENTERPRISES EMPLOYEES' 401K 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 - Trust	Yes
2011: STINE ENTERPRISES EMPLOYEES' 401K 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: STINE ENTERPRISES EMPLOYEES' 401K 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 – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: STINE ENTERPRISES EMPLOYEES' 401K PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

874831

Policy instance

Insurance contract or identification number	874831
Number of Individuals Covered	27
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $623
Total amount of fees paid to insurance company	USD $93
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP PENSION FUNDING
Commission paid to Insurance Broker	USD $623
Insurance broker organization code?	3
Amount paid for insurance broker fees	93
Additional information about fees paid to insurance broker	ADMINISTRATIVE
Insurance broker name	MGKS

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

922364

Policy instance

Insurance contract or identification number	922364
Number of Individuals Covered	34
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $737
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

922364

Policy instance

Insurance contract or identification number	922364
Number of Individuals Covered	37
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $751
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $751
Insurance broker organization code?	4
Insurance broker name	MORGAN STANLEY SMITH BARNEY LLC

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Company Name:	STINE ENTERPRISES, INC.
Employer identification number (EIN):	860501161
NAIC Classification:	722513
NAIC Description:	Limited-Service Restaurants

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	1999-06-30
Company Identification Number:	601964389
Legal Registered Office Address:	17910 NE HOOPER WOLLAM RD YACOLT United States of America (USA) 98675