401k Plan data: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA plan

FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 401k Plan overview

Plan Name	FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA
Plan identification number	001

FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	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.

401k Sponsoring company profile

LI-LI SUBRINA CHIA has sponsored the creation of one or more 401k plans.

Company Name: LI-LI SUBRINA CHIA

Employer identification number (EIN): 330401000

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01 LI-LI CHIA 2020-05-28 LI-LI CHIA 2020-05-28
001 2018-01-01 LI-LI CHIA 2019-04-01 LI-LI CHIA 2019-04-01
001 2017-01-01 LI-LI CHIA 2018-03-30 LI-LI CHIA 2018-03-30
001 2016-01-01 LI-LI CHIA
001 2015-01-01 LI-LI CHIA LI-LI CHIA 2017-04-05
001 2015-01-01 LI-LI CHIA LI-LI CHIA 2017-04-05
001 2014-01-01 LI-LI CHIA LI-LI CHIA 2015-05-15
001 2013-01-01 LI-LI CHIA LI-LI CHIA 2014-06-23

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2019-01-01	LI-LI CHIA	2020-05-28	LI-LI CHIA	2020-05-28
001	2018-01-01	LI-LI CHIA	2019-04-01	LI-LI CHIA	2019-04-01
001	2017-01-01	LI-LI CHIA	2018-03-30	LI-LI CHIA	2018-03-30
001	2016-01-01	LI-LI CHIA
001	2015-01-01	LI-LI CHIA		LI-LI CHIA	2017-04-05
001	2015-01-01	LI-LI CHIA		LI-LI CHIA	2017-04-05
001	2014-01-01	LI-LI CHIA		LI-LI CHIA	2015-05-15
001	2013-01-01	LI-LI CHIA		LI-LI CHIA	2014-06-23

Plan Statistics for FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA

401k plan membership statisitcs for FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA

Measure Date Value
2016: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1
Total of all active and inactive participants 2016-01-01 1
Total participants 2016-01-01 1
2015: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1
Total of all active and inactive participants 2015-01-01 1
Total participants 2015-01-01 1
2014: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1
Total of all active and inactive participants 2014-01-01 1
Total participants 2014-01-01 1
Number of participants with account balances 2014-01-01 1
2013: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1
Total of all active and inactive participants 2013-01-01 1
Total participants 2013-01-01 1

Measure	Date	Value
2016: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1
Total of all active and inactive participants	2016-01-01	1
Total participants	2016-01-01	1
2015: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1
Total of all active and inactive participants	2015-01-01	1
Total participants	2015-01-01	1
2014: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1
Total of all active and inactive participants	2014-01-01	1
Total participants	2014-01-01	1
Number of participants with account balances	2014-01-01	1
2013: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1
Total of all active and inactive participants	2013-01-01	1
Total participants	2013-01-01	1

Financial Data on FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA

Measure	Date	Value
2016 : FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2016 401k financial data
Total income from all sources	2016-12-31	$157,198
Expenses. Total of all expenses incurred	2016-12-31	$187
Total plan assets at end of year	2016-12-31	$518,677
Total plan assets at beginning of year	2016-12-31	$361,666
Total contributions received or receivable from participants	2016-12-31	$24,000
Other income received	2016-12-31	$98,198
Net income (gross income less expenses)	2016-12-31	$157,011
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$518,677
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$361,666
Total contributions received or receivable from employer(s)	2016-12-31	$35,000
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$187
2015 : FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2015 401k financial data
Total income from all sources	2015-12-31	$0
Expenses. Total of all expenses incurred	2015-12-31	$25,610
Total plan assets at end of year	2015-12-31	$361,666
Total plan assets at beginning of year	2015-12-31	$387,276
Expenses. Other expenses not covered elsewhere	2015-12-31	$25,474
Net income (gross income less expenses)	2015-12-31	$-25,610
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$361,666
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$387,276
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$136
2014 : FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2014 401k financial data
Total income from all sources	2014-12-31	$57,500
Expenses. Total of all expenses incurred	2014-12-31	$24,866
Total plan assets at end of year	2014-12-31	$387,276
Total plan assets at beginning of year	2014-12-31	$354,642
Expenses. Other expenses not covered elsewhere	2014-12-31	$24,506
Net income (gross income less expenses)	2014-12-31	$32,634
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$387,276
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$354,642
Total contributions received or receivable from employer(s)	2014-12-31	$57,500
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$360
2013 : FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$130,489
Expenses. Total of all expenses incurred	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$354,642
Total plan assets at beginning of year	2013-12-31	$224,153
Other income received	2013-12-31	$32,489
Net income (gross income less expenses)	2013-12-31	$130,489
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$354,642
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$224,153
Total contributions received or receivable from employer(s)	2013-12-31	$98,000

Form 5500 Responses for FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA

2016: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 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	No
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 – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: FIDELITY SELF-EMPLOYED 401(K) FOR LI-LI S. CHIA 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
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

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Company Name:	LI-LI SUBRINA CHIA
Employer identification number (EIN):	330401000
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)