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FORM 5500 DATA

Walt's Food Center 401k Profit Sharing Plan Trust

Overview

Plan Information

  • Plan Year01/01/2009 — 12/31/2009
  • Date of Plan03/18/1969
  • Net Assets as of 12/31/2009 $5,256,723
  • Plan Number1
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program?Yes
  • Plan Funding Arrangement Trust
  • Plan Benefit Arrangement Trust

Participant Information as of 12/31/2009

  • Active (Eligible) Participants492
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits11
  • Subtotal503
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits1
  • Total504
  • Total number of participants as of 01/01/2009485
  • Number of participants with account balances503
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested10

Expenses

  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address330 W. Taft Drive
  • CitySouth Holland
  • StateIL
  • Zip60473
  • Telephone(708) 596-3166
  • EIN36-2528955
  • Industry Code445110
  • Named AdministratorRobert Lagestee
  • Named Plan SponsorRobert Lagestee

Plan Administrator Information

  • Administrator NameTrustees of Walts Food Center Employee Benefit Plan
  • Address330 W. Taft Drive
  • CitySouth Holland
  • StateIL
  • Zip60473
  • Telephone(708) 596-3166
  • Administrator EIN36-6224617

Audit Information

  • Audit StatusAudited
  • AuditorKlesman Company Pc
  • Auditor EIN36-3606968
  • Audit OpinionUnqualified
  • Audit Type Full Audit

Benefits Provided Under the Plan

Code Benefit Description
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
2G 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.
2J 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.

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? No
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $500,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? No
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? No

Financials

Income and Expense Statement

Income $1,034,919
Contributions $236,384
Cash Contributions $236,384
Cash from Employers $50,000
Cash from Participants $186,384
Others (including rollovers) $0
Noncash Contributions $0
Total Earnings on Investments $797,974
Total Interest $13,173
Interest-Bearing Cash $9,750
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $3,423
Interest from Other Investments $0
Total Dividends $70,076
Preferred Stock $0
Common Stock $6,229
Rents $0
Net gain (loss) on sale of assets $120,680
Aggregate Proceeds $468,435
Aggregate Carrying Amount $347,755
Total Unrealized Appreciation (depreciation) of assets $210,772
Real Estate $0
Other $210,772
Net investment gain (loss) from common/collective trusts $0
Net investment gain (loss) from pooled separate accounts $0
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $383,273
Other Income $561
Expenses $173,155
Total Benefit Payments $150,176
Directly to participants or beneficiaries, including direct rollovers $150,176
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $22,979
Professional Fees $0
Contract Administrator Fees $0
Investment Advisory and management fees $0
Other Administrative Fees $22,979
Net Income $861,764
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2009 12/31/2008 Change YOY
Total Assets $5,290,529 $4,427,152 19.50%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $50,160 $275,000 -81.76%
Employer Contributions $50,000 $275,000 -81.82%
Participant Contributions $160 $0 0.0%
Other Contributions $0 $0 0.0%
General Investments $2,354,871 $2,064,259 14.08%
Interest-bearing cash $2,354,871 $2,064,259 14.08%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $538,412 $294,104 83.07%
Preferred $0 $0 0.0%
Common $538,412 $294,104 83.07%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $65,275 $54,558 19.64%
Value of interest in common/collective trusts $0 $0 0.0%
Value of interest in pooled separate accounts $0 $0 0.0%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $2,281,811 $1,739,231 31.20%
Value of funds held in insurance co. general account $0 $0 0.0%
Other Investments $0 $0 0.0%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $33,806 $32,193 5.01%
Benefit Claims Payable (1) $20,356 $18,743 8.61%
Operating Payables (1) $13,450 $13,450 0.00%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $5,256,723 $4,394,959 19.61%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

There is no information on eligible indirect compensation for this plan.

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
A.M.I.C. Advisors Investment advisory (participants) $23,019 $0 $23,019
Total $23,019 $0 $23,019

Indirect Compensation

There are no service providers with indirect compensation listed for this plan.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

There is no termination information for this plan.

Investments

Investments

No investments information available for this plan.

Insurance Information

Insurance Information

There are no insurance carriers listed for this plan.