Cafeteria Benefit Plan Statement

Year-to-Date Summary

Herculean Tire Co - Fiscal year 2003
Cafeteria Plan Statement

Stanford Q. Burgess

413-22-7702
Cafeteria Plan Statement

1234 East Bovine
Cafeteria Plan Statement

Smithfield

UT

84123-
Cafeteria Plan Statement

Effective Date: 06/30/03
Cafeteria Plan Statement

Flexible Spending Accounts
Cafeteria Plan Statement

Account Name

Deposits

Reimbursements

Current Balance
Cafeteria Plan Statement Cafeteria Plan Statement

Medical Expense

$2,860.00

$82.70

$2,777.30

TOTAL

$2,860.00

$82.70

$2,777.30
Cafeteria Plan Statement Cafeteria Plan Statement

401K Accounts
Cafeteria Plan Statement Cafeteria Plan Statement

Account Name

Beginning Balance

Deposits

Earnings

Withdrawals & Transfers

Ending Balance
Cafeteria Plan Statement Cafeteria Plan Statement

Magellan

$5,000.00

$600.00

$251.41

$0.00

$5,851.41

Vanguard 500

$21,000.00

$600.00

$519.40

$0.00

$22,119.40

Employer Contribution

$31,000.00

$600.00

$0.00

$0.00

$31,600.00
Cafeteria Plan Statement

TOTAL

$57,000.00

$1,800.00

$770.81

$0.00

$59,570.81