401k Plan data: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN plan

FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN
Plan identification number	501

FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. has sponsored the creation of one or more 401k plans.

Company Name: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC.

Employer identification number (EIN): 860103282

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2011-09-01 ROD KEMP
501 2009-09-01 DEBORAH BUDNICK
501 2008-09-01 GAYLE JACKSON

Plan id#	Filing Submission Date	Name of Administrator
501	2011-09-01	ROD KEMP
501	2009-09-01	DEBORAH BUDNICK
501	2008-09-01	GAYLE JACKSON

Plan Statistics for FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN

401k plan membership statisitcs for FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN

Measure Date Value
2011: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-09-01 117
Total number of active participants reported on line 7a of the Form 5500 2011-09-01 109
Number of retired or separated participants receiving benefits 2011-09-01 3
Number of other retired or separated participants entitled to future benefits 2011-09-01 0
Total of all active and inactive participants 2011-09-01 112
2009: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-09-01 116
Total number of active participants reported on line 7a of the Form 5500 2009-09-01 108
Number of retired or separated participants receiving benefits 2009-09-01 2
Number of other retired or separated participants entitled to future benefits 2009-09-01 0
Total of all active and inactive participants 2009-09-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-09-01 0
Total participants 2009-09-01 110
2008: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year 2008-09-01 118
Total number of active participants reported on line 7a of the Form 5500 2008-09-01 98
Number of retired or separated participants receiving benefits 2008-09-01 2
Number of other retired or separated participants entitled to future benefits 2008-09-01 0
Total of all active and inactive participants 2008-09-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-09-01 0
Total participants 2008-09-01 100

Measure	Date	Value
2011: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-09-01	117
Total number of active participants reported on line 7a of the Form 5500	2011-09-01	109
Number of retired or separated participants receiving benefits	2011-09-01	3
Number of other retired or separated participants entitled to future benefits	2011-09-01	0
Total of all active and inactive participants	2011-09-01	112
2009: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-09-01	116
Total number of active participants reported on line 7a of the Form 5500	2009-09-01	108
Number of retired or separated participants receiving benefits	2009-09-01	2
Number of other retired or separated participants entitled to future benefits	2009-09-01	0
Total of all active and inactive participants	2009-09-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-09-01	0
Total participants	2009-09-01	110
2008: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year	2008-09-01	118
Total number of active participants reported on line 7a of the Form 5500	2008-09-01	98
Number of retired or separated participants receiving benefits	2008-09-01	2
Number of other retired or separated participants entitled to future benefits	2008-09-01	0
Total of all active and inactive participants	2008-09-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-09-01	0
Total participants	2008-09-01	100

Form 5500 Responses for FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN

2011: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-09-01	Type of plan entity	Single employer plan
2011-09-01	First time form 5500 has been submitted	Yes
2011-09-01	Submission has been amended	Yes
2011-09-01	This submission is the final filing	No
2011-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-09-01	Plan is a collectively bargained plan	No
2011-09-01	Plan funding arrangement – Insurance	Yes
2011-09-01	Plan benefit arrangement – Insurance	Yes
2009: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-09-01	Type of plan entity	Single employer plan
2009-09-01	First time form 5500 has been submitted	Yes
2009-09-01	Submission has been amended	No
2009-09-01	This submission is the final filing	No
2009-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-09-01	Plan is a collectively bargained plan	No
2009-09-01	Plan funding arrangement – Insurance	Yes
2009-09-01	Plan benefit arrangement – Insurance	Yes
2008: FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. WELFARE BENEFITS PLAN 2008 form 5500 responses
2008-09-01	Type of plan entity	Single employer plan
2008-09-01	First time form 5500 has been submitted	Yes
2008-09-01	Submission has been amended	No
2008-09-01	This submission is the final filing	No
2008-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-09-01	Plan is a collectively bargained plan	No
2008-09-01	Plan funding arrangement – Insurance	Yes
2008-09-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	FLORENCE CRITTENTON SERVICES OF ARIZONA, INC.
Employer identification number (EIN):	860103282
NAIC Classification:	611000