401k Plan data: URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN plan

URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN
Plan identification number	001

URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.

401k Sponsoring company profile

URGENT CARE OF PAWTUCKET has sponsored the creation of one or more 401k plans.

Company Name: URGENT CARE OF PAWTUCKET

Employer identification number (EIN): 050512324

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 JAMES O'HAIR
001 2010-01-01 JAMES O'HAIR

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2011-01-01	JAMES O'HAIR
001	2010-01-01	JAMES O'HAIR

Plan Statistics for URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN

Measure Date Value
2011: URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 0
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
2010: URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 4
Number of participants with account balances 2010-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2011: URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	0
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
2010: URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	4
Number of participants with account balances	2010-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2011 : URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN 2011 401k financial data
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	$5,344
Expenses. Total of all expenses incurred	2011-12-31	$14,673
Benefits paid (including direct rollovers)	2011-12-31	$14,673
Total plan assets at end of year	2011-12-31	$0
Total plan assets at beginning of year	2011-12-31	$9,329
Total contributions received or receivable from participants	2011-12-31	$1,175
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	$-978
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-9,329
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$9,329
Total contributions received or receivable from employer(s)	2011-12-31	$5,147
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
2010 : URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN 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	$9,943
Expenses. Total of all expenses incurred	2010-12-31	$614
Benefits paid (including direct rollovers)	2010-12-31	$539
Total plan assets at end of year	2010-12-31	$9,329
Total plan assets at beginning of year	2010-12-31	$0
Total contributions received or receivable from participants	2010-12-31	$4,669
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	$1,012
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$9,329
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$9,329
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$0
Total contributions received or receivable from employer(s)	2010-12-31	$4,262
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	$75
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN

2011: URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN 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	Yes
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
2010: URGENT CARE OF PAWTUCKET 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
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

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Company Name:	URGENT CARE OF PAWTUCKET
Employer identification number (EIN):	050512324
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)