401k Plan data: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 plan

FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 401k Plan overview

Plan Name	FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484
Plan identification number	001

FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Money purchase (other than target benefit) Profit-sharing Plan covering Self-Employed individuals. Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.

401k Sponsoring company profile

FELIX A. JIMENEZ GARCIA has sponsored the creation of one or more 401k plans.

Company Name: FELIX A. JIMENEZ GARCIA

Employer identification number (EIN): 223330253

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 MARIA DE LOURDES CRUZ
001 2013-01-01 BRENDA HERNANDEZ RODRIGUEZ
001 2012-01-01 BRENDA HERNANDEZ RODRIGUEZ
001 2011-01-01 BRENDA HERNANDEZ RODRIGUEZ
001 2009-01-01 FELIX A. JIMENEZ GARCIA FELIX A. JIMENEZ GARCIA 2010-07-08

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	MARIA DE LOURDES CRUZ
001	2013-01-01	BRENDA HERNANDEZ RODRIGUEZ
001	2012-01-01	BRENDA HERNANDEZ RODRIGUEZ
001	2011-01-01	BRENDA HERNANDEZ RODRIGUEZ
001	2009-01-01	FELIX A. JIMENEZ GARCIA	FELIX A. JIMENEZ GARCIA	2010-07-08

Plan Statistics for FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484

401k plan membership statisitcs for FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484

Measure Date Value
2014: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2014 401k membership
Total participants, beginning-of-year 2014-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 2
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 2
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 2
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 2
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 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 2
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2014: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2014 401k membership
Total participants, beginning-of-year	2014-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	2
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	2
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	2
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2
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	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	2
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484

Measure	Date	Value
2014 : FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$4,778
Total income from all sources	2014-12-31	$4,778
Expenses. Total of all expenses incurred	2014-12-31	$377,738
Benefits paid (including direct rollovers)	2014-12-31	$377,738
Total plan assets at end of year	2014-12-31	$0
Total plan assets at beginning of year	2014-12-31	$377,738
Total contributions received or receivable from participants	2014-12-31	$0
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$4,778
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$-372,960
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$372,960
Total contributions received or receivable from employer(s)	2014-12-31	$0
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$4,778
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$-357,235
Expenses. Total of all expenses incurred	2013-12-31	$0
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$377,738
Total plan assets at beginning of year	2013-12-31	$730,195
Total contributions received or receivable from participants	2013-12-31	$0
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$-357,235
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$-357,235
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$372,960
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$730,195
Total contributions received or receivable from employer(s)	2013-12-31	$0
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$0
2012 : FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$24,632
Expenses. Total of all expenses incurred	2012-12-31	$0
Benefits paid (including direct rollovers)	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$730,195
Total plan assets at beginning of year	2012-12-31	$705,563
Total contributions received or receivable from participants	2012-12-31	$0
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$16,632
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$24,632
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$730,195
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$705,563
Total contributions received or receivable from employer(s)	2012-12-31	$8,000
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$0
2011 : FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$107,844
Expenses. Total of all expenses incurred	2011-12-31	$0
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$705,563
Total plan assets at beginning of year	2011-12-31	$597,719
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$98,386
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$107,844
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$705,563
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$597,719
Total contributions received or receivable from employer(s)	2011-12-31	$9,458
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$9,458
Amount contributed by the employer to the plan for this plan year	2011-12-31	$9,458
2010 : FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 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	$43,861
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	$597,719
Total plan assets at beginning of year	2010-12-31	$553,858
Total contributions received or receivable from 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	$33,861
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$43,861
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$597,719
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$553,858
Total contributions received or receivable from employer(s)	2010-12-31	$10,000
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$-205
Minimum employer required contribution for this plan year	2010-12-31	$9,795
Amount contributed by the employer to the plan for this plan year	2010-12-31	$10,000
2009 : FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2009 401k financial data
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	$8,852
Amount contributed by the employer to the plan for this plan year	2009-12-31	$8,852

Form 5500 Responses for FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484

2014: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: FELIX A. JIMENEZ GARCIA RETIREMENT PLAN SERIES 91-484 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

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Company Name:	FELIX A. JIMENEZ GARCIA
Employer identification number (EIN):	223330253
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)