401k Plan data: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN plan

JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN
Plan identification number	535

JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision

401k Sponsoring company profile

JACK IN THE BOX INC. has sponsored the creation of one or more 401k plans.

Company Name: JACK IN THE BOX INC.

Employer identification number (EIN): 952698708

NAIC Classification: 722513
NAIC Description: Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
535 2016-10-01 STEPHANIE BRINSFIELD
535 2015-10-01 STEPHANIE BRINSFIELD
535 2014-10-01 STEPHANIE BRINSFIELD
535 2013-10-01 STEPHANIE BRINSFIELD
535 2012-10-01 STEPHANIE BRINSFIELD STEPHANIE BRINSFIELD 2014-03-28
535 2011-10-01 STEPHANIE BRINSFIELD
535 2010-10-01 STEPHANIE BRINSFIELD
535 2009-10-01 STEPHANIE BRINSFIELD
535 2008-10-01

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
535	2016-10-01	STEPHANIE BRINSFIELD
535	2015-10-01	STEPHANIE BRINSFIELD
535	2014-10-01	STEPHANIE BRINSFIELD
535	2013-10-01	STEPHANIE BRINSFIELD
535	2012-10-01	STEPHANIE BRINSFIELD	STEPHANIE BRINSFIELD	2014-03-28
535	2011-10-01	STEPHANIE BRINSFIELD
535	2010-10-01	STEPHANIE BRINSFIELD
535	2009-10-01	STEPHANIE BRINSFIELD
535	2008-10-01

Plan Statistics for JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN

401k plan membership statisitcs for JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN

Measure Date Value
2016: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 275
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 0
Number of retired or separated participants receiving benefits 2016-10-01 0
Number of other retired or separated participants entitled to future benefits 2016-10-01 0
Total of all active and inactive participants 2016-10-01 0
2015: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 581
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 345
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 0
Total of all active and inactive participants 2015-10-01 345
2014: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 350
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 288
Number of retired or separated participants receiving benefits 2014-10-01 1
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 289
2013: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 361
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 350
Number of retired or separated participants receiving benefits 2013-10-01 0
Number of other retired or separated participants entitled to future benefits 2013-10-01 0
Total of all active and inactive participants 2013-10-01 350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-10-01 0
2012: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 412
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 349
Number of retired or separated participants receiving benefits 2012-10-01 12
Number of other retired or separated participants entitled to future benefits 2012-10-01 0
Total of all active and inactive participants 2012-10-01 361
2011: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 590
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 398
Number of retired or separated participants receiving benefits 2011-10-01 14
Number of other retired or separated participants entitled to future benefits 2011-10-01 0
Total of all active and inactive participants 2011-10-01 412
2010: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-10-01 985
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 572
Number of retired or separated participants receiving benefits 2010-10-01 18
Number of other retired or separated participants entitled to future benefits 2010-10-01 0
Total of all active and inactive participants 2010-10-01 590
2009: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 1,080
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 963
Number of retired or separated participants receiving benefits 2009-10-01 22
Number of other retired or separated participants entitled to future benefits 2009-10-01 0
Total of all active and inactive participants 2009-10-01 985

Measure	Date	Value
2016: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	275
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	0
Number of retired or separated participants receiving benefits	2016-10-01	0
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	0
2015: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	581
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	345
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	345
2014: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	350
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	288
Number of retired or separated participants receiving benefits	2014-10-01	1
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	289
2013: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	361
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	350
Number of retired or separated participants receiving benefits	2013-10-01	0
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-10-01	0
2012: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	412
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	349
Number of retired or separated participants receiving benefits	2012-10-01	12
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	361
2011: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	590
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	398
Number of retired or separated participants receiving benefits	2011-10-01	14
Number of other retired or separated participants entitled to future benefits	2011-10-01	0
Total of all active and inactive participants	2011-10-01	412
2010: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-10-01	985
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	572
Number of retired or separated participants receiving benefits	2010-10-01	18
Number of other retired or separated participants entitled to future benefits	2010-10-01	0
Total of all active and inactive participants	2010-10-01	590
2009: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	1,080
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	963
Number of retired or separated participants receiving benefits	2009-10-01	22
Number of other retired or separated participants entitled to future benefits	2009-10-01	0
Total of all active and inactive participants	2009-10-01	985

Form 5500 Responses for JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN

2016: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	Yes
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2010 form 5500 responses
2010-10-01	Type of plan entity	Single employer plan
2010-10-01	Submission has been amended	No
2010-10-01	This submission is the final filing	No
2010-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-10-01	Plan is a collectively bargained plan	No
2010-10-01	Plan funding arrangement – Insurance	Yes
2010-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-10-01	Plan benefit arrangement – Insurance	Yes
2010-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2008: JACK IN THE BOX INC. VARIABLE HOUR HEALTH & WELFARE BENEFITS PLAN 2008 form 5500 responses
2008-10-01	Type of plan entity	Single employer plan
2008-10-01	Submission has been amended	No
2008-10-01	This submission is the final filing	No
2008-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-10-01	Plan is a collectively bargained plan	No

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Company Name:	JACK IN THE BOX INC.
Employer identification number (EIN):	952698708
NAIC Classification:	722513
NAIC Description:	Limited-Service Restaurants