401k Plan data: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. plan

TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 401k Plan overview

Plan Name	TAX DEFERRED ANNUITY PLAN OF OTSAR, INC.
Plan identification number	001

TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

OTSAR, INC. has sponsored the creation of one or more 401k plans.

Company Name: OTSAR, INC.

Employer identification number (EIN): 112601112

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Additional information about OTSAR, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1989-10-18

Company Identification Number: L23538

Legal Registered Office Address: 5315 TROUBLE CREEK RD.

NEW PORT RICHEY

34652

More information about OTSAR, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED ANNUITY PLAN OF OTSAR, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-03-01 BETTY POLLACK BETTY POLLACK 2013-09-30
001 2012-01-01 BETTY POLLACK
001 2011-01-01 BETTY POLLACK
001 2009-01-01 BETTY POLLACK BETTY POLLACK 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2012-03-01	BETTY POLLACK	BETTY POLLACK	2013-09-30
001	2012-01-01	BETTY POLLACK
001	2011-01-01	BETTY POLLACK
001	2009-01-01	BETTY POLLACK	BETTY POLLACK	2010-10-15

Plan Statistics for TAX DEFERRED ANNUITY PLAN OF OTSAR, INC.

401k plan membership statisitcs for TAX DEFERRED ANNUITY PLAN OF OTSAR, INC.

Measure Date Value
2012: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2012 401k membership
Total participants, beginning-of-year 2012-03-01 2
Total number of active participants reported on line 7a of the Form 5500 2012-03-01 0
Number of retired or separated participants receiving benefits 2012-03-01 0
Number of other retired or separated participants entitled to future benefits 2012-03-01 0
Total of all active and inactive participants 2012-03-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-03-01 0
Total participants 2012-03-01 0
Number of participants with account balances 2012-03-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-03-01 0
Total participants, beginning-of-year 2012-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2
Total of all active and inactive participants 2012-01-01 2
Total participants 2012-01-01 2
Number of participants with account balances 2012-01-01 2
2011: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3
Total of all active and inactive participants 2011-01-01 3
Total participants 2011-01-01 3
Number of participants with account balances 2011-01-01 3
2009: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3
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 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 3
Number of participants with account balances 2009-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2012 401k membership
Total participants, beginning-of-year	2012-03-01	2
Total number of active participants reported on line 7a of the Form 5500	2012-03-01	0
Number of retired or separated participants receiving benefits	2012-03-01	0
Number of other retired or separated participants entitled to future benefits	2012-03-01	0
Total of all active and inactive participants	2012-03-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-03-01	0
Total participants	2012-03-01	0
Number of participants with account balances	2012-03-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-03-01	0
Total participants, beginning-of-year	2012-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2
Total of all active and inactive participants	2012-01-01	2
Total participants	2012-01-01	2
Number of participants with account balances	2012-01-01	2
2011: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3
Total of all active and inactive participants	2011-01-01	3
Total participants	2011-01-01	3
Number of participants with account balances	2011-01-01	3
2009: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3
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	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	3
Number of participants with account balances	2009-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on TAX DEFERRED ANNUITY PLAN OF OTSAR, INC.

Measure	Date	Value
2013 : TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2013 401k financial data
Value of total assets at end of year	2013-02-28	$0
Value of total assets at beginning of year	2013-02-28	$147,643
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-02-28	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2013-02-28	$0
Was this plan covered by a fidelity bond	2013-02-28	Yes
Value of fidelity bond cover	2013-02-28	$20,000
If this is an individual account plan, was there a blackout period	2013-02-28	No
Were there any nonexempt tranactions with any party-in-interest	2013-02-28	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-02-28	No
Value of net assets at end of year (total assets less liabilities)	2013-02-28	$0
Value of net assets at beginning of year (total assets less liabilities)	2013-02-28	$147,643
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-02-28	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-02-28	No
Were any leases to which the plan was party in default or uncollectible	2013-02-28	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-02-28	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-02-28	$147,643
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-02-28	No
Was there a failure to transmit to the plan any participant contributions	2013-02-28	No
Has the plan failed to provide any benefit when due under the plan	2013-02-28	No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-02-28	No
Did the plan have assets held for investment	2013-02-28	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-02-28	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-02-28	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-02-28	Yes
Opinion of an independent qualified public accountant for this plan	2013-02-28	Disclaimer
Accountancy firm name	2013-02-28	SOLOMON KAUFMAN
Accountancy firm EIN	2013-02-28	133381550
2012 : TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2012 401k financial data
Total income from all sources (including contributions)	2012-02-29	$1,869
Total of all expenses incurred	2012-02-29	$4
Value of total assets at end of year	2012-02-29	$147,643
Value of total assets at beginning of year	2012-02-29	$177,133
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-02-29	$4
Total interest from all sources	2012-02-29	$1,869
Was this plan covered by a fidelity bond	2012-02-29	Yes
Value of fidelity bond cover	2012-02-29	$20,000
If this is an individual account plan, was there a blackout period	2012-02-29	No
Were there any nonexempt tranactions with any party-in-interest	2012-02-29	No
Administrative expenses (other) incurred	2012-02-29	$4
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-02-29	No
Value of net income/loss	2012-02-29	$1,865
Value of net assets at end of year (total assets less liabilities)	2012-02-29	$147,643
Value of net assets at beginning of year (total assets less liabilities)	2012-02-29	$177,133
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-02-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-02-29	No
Were any leases to which the plan was party in default or uncollectible	2012-02-29	No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-02-29	$30,194
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-02-29	$1,869
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-02-29	$147,643
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-02-29	$146,939
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-02-29	No
Was there a failure to transmit to the plan any participant contributions	2012-02-29	No
Has the plan failed to provide any benefit when due under the plan	2012-02-29	No
Did the plan have assets held for investment	2012-02-29	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-02-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-02-29	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-02-29	Yes
Opinion of an independent qualified public accountant for this plan	2012-02-29	Disclaimer
Accountancy firm name	2012-02-29	SOLOMON KAUFMAN
Accountancy firm EIN	2012-02-29	133381550
2011 : TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$4,281
Total of all expenses incurred	2011-12-31	$48
Value of total assets at end of year	2011-12-31	$177,133
Value of total assets at beginning of year	2011-12-31	$172,900
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$48
Total interest from all sources	2011-12-31	$4,281
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$20,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Administrative expenses (other) incurred	2011-12-31	$48
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$4,233
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$177,133
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$172,900
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$30,194
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$30,191
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$4,281
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$146,939
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$142,709
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	SOLOMON KAUFMAN
Accountancy firm EIN	2011-12-31	133381550
2010 : TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$17,519
Total of all expenses incurred	2010-12-31	$59
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$9,826
Value of total assets at end of year	2010-12-31	$172,900
Value of total assets at beginning of year	2010-12-31	$155,442
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$59
Total interest from all sources	2010-12-31	$4,044
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$20,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$9,826
Administrative expenses (other) incurred	2010-12-31	$59
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$17,460
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$172,900
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$155,442
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$30,191
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$26,565
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$4,044
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$142,709
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$128,877
Net investment gain/loss from pooled separate accounts	2010-12-31	$3,649
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	SOLOMON KAUFMAN
Accountancy firm EIN	2010-12-31	133381550
2009 : TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 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

Form 5500 Responses for TAX DEFERRED ANNUITY PLAN OF OTSAR, INC.

2012: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 2012 form 5500 responses
2012-03-01	Type of plan entity	Single employer plan
2012-03-01	Submission has been amended	No
2012-03-01	This submission is the final filing	Yes
2012-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-03-01	Plan is a collectively bargained plan	No
2012-03-01	Plan funding arrangement – Insurance	Yes
2012-03-01	Plan benefit arrangement – Insurance	Yes
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)	Yes
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: TAX DEFERRED ANNUITY PLAN OF OTSAR, INC. 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 – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	OTSAR, INC.
Employer identification number (EIN):	112601112
NAIC Classification:	624100
NAIC Description:	Individual and Family Services

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1989-10-18
Company Identification Number:	L23538
Legal Registered Office Address:	5315 TROUBLE CREEK RD. NEW PORT RICHEY 34652