401k Plan data: DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST plan

DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST
Plan identification number	001

DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing 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

DR DAVID JENKINS CATSKILL ANIMAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: DR DAVID JENKINS CATSKILL ANIMAL HOSPITAL

Employer identification number (EIN): 141675572

NAIC Classification: 541940
NAIC Description: Veterinary Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 DR DAVID JENKINS 2014-02-17
001 2012-01-01 DR DAVID JENKINS 2013-01-29
001 2011-01-01 DR DAVID JENKINS 2012-08-28
001 2010-01-01 DR DAVID JENKINS
001 2009-01-01 DAVID JENKINS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2013-01-01	DR DAVID JENKINS	2014-02-17
001	2012-01-01	DR DAVID JENKINS	2013-01-29
001	2011-01-01	DR DAVID JENKINS	2012-08-28
001	2010-01-01	DR DAVID JENKINS
001	2009-01-01	DAVID JENKINS

Plan Statistics for DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST

Measure Date Value
2010: DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 7
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 0
Total of all active and inactive participants 2010-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 7
Number of participants with account balances 2010-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6
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 0
Total of all active and inactive participants 2009-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 6
Number of participants with account balances 2009-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2010: DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	7
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	0
Total of all active and inactive participants	2010-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	7
Number of participants with account balances	2010-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6
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	0
Total of all active and inactive participants	2009-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	6
Number of participants with account balances	2009-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2010 : DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$100,629
Expenses. Total of all expenses incurred	2010-12-31	$0
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$833,891
Total plan assets at beginning of year	2010-12-31	$733,262
Value of fidelity bond covering the plan	2010-12-31	$0
Assets. Value of tangible personal property	2010-12-31	$0
Total contributions received or receivable from participants	2010-12-31	$0
Assets. Value of loans (other than to participants)	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$64,873
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$100,629
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$833,891
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$733,262
Assets. Value of participant loans	2010-12-31	$0
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2010-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2010-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$0
Assets. Value of real-estate (other than employer real property)	2010-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2010-12-31	$0
Assets. Value of employer securities	2010-12-31	$0
Assets. Value of employer real property	2010-12-31	$0
Total contributions received or receivable from employer(s)	2010-12-31	$35,756
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	$0
2009 : DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST 2009 401k financial data
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2009-12-31	0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST

2010: DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: DR DAVID H JENKINS CATSKILL ANIMAL HOSPITAL PROFIT SHARING PLAN AND TRUST 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONAL INTEGRITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 75264 )

Policy contract number

50858

Policy instance

Insurance contract or identification number	50858
Number of Individuals Covered	7
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $715
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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?	No
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
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $715
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ROBERT CORY

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Company Name:	DR DAVID JENKINS CATSKILL ANIMAL HOSPITAL
Employer identification number (EIN):	141675572
NAIC Classification:	541940
NAIC Description:	Veterinary Services