2012-11-15T08:36:25-06:00 2011-12-31 251408703 SCHNEIDER DOWNS & CO INC 1133 PENN AVENUE PITTSBURGH PA 15222 990 2011-01-01 266204005 DSW INC BENEFIT PLAN DSWI 6148721470 810 DSW DRIVE COLUMBUS OH 43219 KURT GATTERDAM 6142387100 2012-11-15 SUSAN M KIRSCH P00341397 4122613644 2011 2016-02-24 21:20:13Z DOUGLAS J PROBST 810 DSW DRIVE COLUMBUS OH 43219 16399555 0 X N/A X 2008 OH THE ORGANIZATION IS A VOLUNTARY EMPLOYEES' BENEFIT ASSOCIATION (VEBA) 0 0 0 0 0 0 0 0 5394352 16099092 589 95 22796 300368 5417737 16399555 0 0 4071417 12096416 449 1000 0 0 0 689589 2672690 4761455 14770106 656282 1629449 1468433 3084438 14506 1062 1453927 3083376 THE ORGANIZATION IS A VOLUNTARY EMPLOYEES' BENEFIT ASSOCIATION (VEBA). 0 0 PROVISION OF BENEFITS TO DSW, INC. EMPLOYEES AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 X KURT GATTERDAM 6148721300 810 DSW DRIVE COLUMBUS OH 43219 PNC BANK 2.00 X 1000 0 0 DOUGLAS PROBST 1.00 X 0 0 0 1000 0 0 0 0 0 0 ANTHEM 86 COLUMBUS ROAD ATHENS OH 45701 PLAN ADMINISTRATION FEES 1060738 1 EMPLOYER PREMIUMS 900099 8978621 8978621 EMPLOYEE PREMIUMS 900099 7120471 7120471 16099092 95 95 CAREMARK REBATE 900099 271578 271578 MISCELLANEOUS INCOME 900099 28790 28790 300368 16399555 16399460 0 95 12096416 1000 1400448 1272242 14770106 242680 503591 813472 2168566 412281 0 0 412281 1468433 3084438 14506 1062 14506 1062 X 0 0 0 0 1453927 3083376 1453927 3083376 1468433 3084438 1629449 0 X X 0 1 0 X 0 0 16399555 14770106 1629449 1629449 16399555 0 16399555 0 16399555 14770106 0 14770106 0 14770106 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE COMPANY HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAIN UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINSTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2008. DSW INC X 412281 412281 0 0 0 412281 SCHEDULE L, PART II DURING JULY 2011, A RECEIVABLE IN THE AMOUNT OF $412,281 DUE TO THE PLAN FROM AN AFFILIATE PLAN WAS REPAID TO THE COMPANY RATHER THAN THE PLAN. THIS TRANSACTION IS CONSIDERED A LOAN FROM THE PLAN TO THE COMPANY AND IS THEREFORE DEEMED TO BE A PROHIBITED TRANSACTION. THE FULL AMOUNT WAS REPAID TO THE PLAN IN FEBRUARY 2012. IN ADDITION, THE COMPANY WILL REPAY ANY LOST EARNINGS TO THE PLAN IN 2012. FORM 990, PART VI, SECTION A, LINE 8A THE ORGANIZATION IS A VOLUNTARY EMPLOYEES' BENEFIT ASSOCIATION (VEBA). AS A TRUST, THE VEBA DOES NOT HAVE A DEFINED GOVERNING BODY COMPOSED OF A BOARD OF DIRECTORS, BUT INSTEAD IS GOVERNED BY A TRUST AGREEMENT. A COMMERCIAL BANKING INSTITUTION IS APPOINTED AS TRUSTEE BY THE SPONSORING ORGANIZATION IN THE TRUST AGREEMENT. THE SPONSORING INSTITUTION SHALL AT ALL TIMES ENSURE THAT NAMED FIDUCIARIES ARE APPOINTED FOR THE PLAN, WHO SHALL BE RESPONSIBLE FOR THE CONTROL OF THE VEBA ESTABLISHED IN CONNECTION WITH THE TRUST FUND. SUCH NAMED FIDUCIARIES SHALL BE RESPONSIBLE FOR THE OPERATION AND ADMINISTRATION OF THE PLAN. TO ACCOMPLISH ADMINISTRATION AND PAYMENT OF BENEFITS UNDER THE PLAN, THE PRIMARY SPONSOR OF THE PLAN ENGAGED A BENEFITS ADMINISTRATOR TO SERVE AS THE AGENT FOR THE ADMINISTRATION AND PAYMENT OF BENEFITS UNDER THE PLAN. THE BENEFITS ADMINISTRATOR MAY BE CHANGED FROM TIME TO TIME AND THE PLAN SPONSOR SHALL PROVIDE THE TRUSTEE WITH WRITTEN NOTIFICATION OF ANY CHANGE. THE TRUSTEE SHALL MAKE DISTRIBUTION FROM THE TRUST FUND IN THE MANNER PROVIDED FOR UNDER THE TERMS OF THE TRUST AGREEMENT AND IN SUCH AMOUNTS AS ARE DIRECTED IN WRITING BY THE PLAN SPONSOR OR BENEFITS ADMINISTRATOR. BOARD MEETINGS ARE NOT HELD AND ACCORDINGLY THERE ARE NO BOARD MINUTES DOCUMENTED. FORM 990, PART VI, SECTION A, LINE 8B SEE EXPLANATION FOR LINE 8A ABOVE. THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE TRUST AND ITS NAMED FIDUCIARIES. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE REVIEWED BY THE ORGANIZATION'S PRINCIPAL OFFICER AND FIDUCIARY. A COPY OF THE FORM 990 IS PROVIDED TO THE INSTITUTIONAL TRUSTEE BEFORE FILING WITH THE SERVICE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS WILL BE PROVIDED UPON REQUEST. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII PNC BANK - 155 EAST BROAD STREET, COLUMBUS, OH 43215. COMMITTEE OVERSIGHT FORM 990, PART XII, FINANCIAL STATEMENTS AND REPORTING THE VEBA DOES NOT HAVE A COMMITTEE THAT ASSUMES RESPONSIBILITY OR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. HOWEVER, THE DIRECTOR OF COMPENSATION AND BENEFITS OF THE PLAN'S SPONSORING ORGANIZATION DOES ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF FINANCIAL STATEMENTS. DSW INC 810 DSW DRIVE COLUMBUS OH 43219 310746639 BENEFIT PLAN SPONSOR OH C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0