401k Plan data: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN plan

CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN
Plan identification number	001

CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
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 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CENTER FOR PSYCHOLOGICAL SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: CENTER FOR PSYCHOLOGICAL SERVICES, LLC

Employer identification number (EIN): 232830593

NAIC Classification: 621330
NAIC Description: Offices of Mental Health Practitioners (except Physicians)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01 IAN HARING
001 2015-01-01 IAN HARING
001 2014-01-01 IAN HARING
001 2013-01-01 IAN HARING IAN HARING 2014-06-26
001 2012-01-01 IAN HARING IAN HARING 2013-07-25
001 2011-01-01 IAN HARING IAN HARING 2012-07-19
001 2010-01-01 IAN HARING IAN HARING 2011-10-13
001 2009-01-01 IAN HARING IAN HARING 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01
001	2016-01-01	IAN HARING
001	2015-01-01	IAN HARING
001	2014-01-01	IAN HARING
001	2013-01-01	IAN HARING	IAN HARING	2014-06-26
001	2012-01-01	IAN HARING	IAN HARING	2013-07-25
001	2011-01-01	IAN HARING	IAN HARING	2012-07-19
001	2010-01-01	IAN HARING	IAN HARING	2011-10-13
001	2009-01-01	IAN HARING	IAN HARING	2010-10-13

Plan Statistics for CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN

401k plan membership statisitcs for CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN

Measure Date Value
2017: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 2
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 2
Number of participants with account balances 2016-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 8
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 1
Total of all active and inactive participants 2015-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 9
Number of participants with account balances 2015-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 7
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 1
Total of all active and inactive participants 2014-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 8
Number of participants with account balances 2014-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 6
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 1
Total of all active and inactive participants 2013-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 7
Number of participants with account balances 2013-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 6
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 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 6
Number of participants with account balances 2012-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 6
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 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 6
Number of participants with account balances 2011-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 5
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 1
Total of all active and inactive participants 2010-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 6
Number of participants with account balances 2010-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 5
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 1
Total of all active and inactive participants 2009-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 6
Number of participants with account balances 2009-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2017: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	2
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	2
Number of participants with account balances	2016-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	8
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	1
Total of all active and inactive participants	2015-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	9
Number of participants with account balances	2015-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	7
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	1
Total of all active and inactive participants	2014-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	8
Number of participants with account balances	2014-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	6
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	1
Total of all active and inactive participants	2013-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	7
Number of participants with account balances	2013-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	6
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	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	6
Number of participants with account balances	2012-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	6
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	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	6
Number of participants with account balances	2011-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	5
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	1
Total of all active and inactive participants	2010-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	6
Number of participants with account balances	2010-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	5
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	1
Total of all active and inactive participants	2009-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	6
Number of participants with account balances	2009-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN

Measure	Date	Value
2017 : CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2017 401k financial data
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$25,000
Total income from all sources	2017-12-31	$-100,000
Expenses. Total of all expenses incurred	2017-12-31	$331
Benefits paid (including direct rollovers)	2017-12-31	$331
Total plan assets at end of year	2017-12-31	$0
Total plan assets at beginning of year	2017-12-31	$125,331
Value of fidelity bond covering the plan	2017-12-31	$425,000
Total contributions received or receivable from participants	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$-100,000
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$-100,331
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$100,331
Total contributions received or receivable from employer(s)	2017-12-31	$0
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at end of year	2016-12-31	$25,000
Total plan liabilities at beginning of year	2016-12-31	$25,000
Total income from all sources	2016-12-31	$77,915
Expenses. Total of all expenses incurred	2016-12-31	$2,858,395
Benefits paid (including direct rollovers)	2016-12-31	$2,854,544
Total plan assets at end of year	2016-12-31	$125,331
Total plan assets at beginning of year	2016-12-31	$2,905,811
Value of fidelity bond covering the plan	2016-12-31	$425,000
Total contributions received or receivable from participants	2016-12-31	$0
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$77,915
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$-2,780,480
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$100,331
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$2,880,811
Total contributions received or receivable from employer(s)	2016-12-31	$0
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$3,851
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$25,000
Total plan liabilities at beginning of year	2015-12-31	$13,079
Total income from all sources	2015-12-31	$-49,662
Expenses. Total of all expenses incurred	2015-12-31	$68,504
Benefits paid (including direct rollovers)	2015-12-31	$64,005
Total plan assets at end of year	2015-12-31	$2,905,811
Total plan assets at beginning of year	2015-12-31	$3,012,056
Value of fidelity bond covering the plan	2015-12-31	$425,000
Total contributions received or receivable from participants	2015-12-31	$27,396
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-95,793
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-118,166
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$2,880,811
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$2,998,977
Total contributions received or receivable from employer(s)	2015-12-31	$18,735
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$4,499
2014 : CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$13,079
Total plan liabilities at beginning of year	2014-12-31	$13,086
Total income from all sources	2014-12-31	$90,762
Expenses. Total of all expenses incurred	2014-12-31	$129,838
Benefits paid (including direct rollovers)	2014-12-31	$123,868
Total plan assets at end of year	2014-12-31	$3,012,056
Total plan assets at beginning of year	2014-12-31	$3,051,139
Value of fidelity bond covering the plan	2014-12-31	$425,000
Total contributions received or receivable from participants	2014-12-31	$30,096
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	$11,466
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$-39,076
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,998,977
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$3,038,053
Total contributions received or receivable from employer(s)	2014-12-31	$49,200
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	$5,970
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$13,086
Total plan liabilities at beginning of year	2013-12-31	$13,086
Total income from all sources	2013-12-31	$598,100
Expenses. Total of all expenses incurred	2013-12-31	$67,234
Benefits paid (including direct rollovers)	2013-12-31	$57,000
Total plan assets at end of year	2013-12-31	$3,051,139
Total plan assets at beginning of year	2013-12-31	$2,520,273
Value of fidelity bond covering the plan	2013-12-31	$350,000
Total contributions received or receivable from participants	2013-12-31	$30,667
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	$518,745
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$530,866
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$3,038,053
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$2,507,187
Total contributions received or receivable from employer(s)	2013-12-31	$48,688
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	$10,234
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$13,086
Total plan liabilities at beginning of year	2012-12-31	$10,086
Total income from all sources	2012-12-31	$338,096
Expenses. Total of all expenses incurred	2012-12-31	$30,012
Benefits paid (including direct rollovers)	2012-12-31	$23,602
Total plan assets at end of year	2012-12-31	$2,520,273
Total plan assets at beginning of year	2012-12-31	$2,209,188
Value of fidelity bond covering the plan	2012-12-31	$350,000
Total contributions received or receivable from participants	2012-12-31	$28,357
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	$263,114
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$308,084
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$2,507,187
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,199,102
Total contributions received or receivable from employer(s)	2012-12-31	$46,625
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	$6,410
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$10,086
Total plan liabilities at beginning of year	2011-12-31	$87
Total income from all sources	2011-12-31	$-28,182
Expenses. Total of all expenses incurred	2011-12-31	$89,918
Benefits paid (including direct rollovers)	2011-12-31	$82,159
Total plan assets at end of year	2011-12-31	$2,209,188
Total plan assets at beginning of year	2011-12-31	$2,317,289
Value of fidelity bond covering the plan	2011-12-31	$350,000
Total contributions received or receivable from participants	2011-12-31	$27,987
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	$-98,062
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-118,100
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,199,102
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,317,202
Total contributions received or receivable from employer(s)	2011-12-31	$41,893
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	$7,759
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K 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	$87
Total plan liabilities at beginning of year	2010-12-31	$87
Total income from all sources	2010-12-31	$440,341
Expenses. Total of all expenses incurred	2010-12-31	$6,228
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$2,317,289
Total plan assets at beginning of year	2010-12-31	$1,883,176
Value of fidelity bond covering the plan	2010-12-31	$350,000
Total contributions received or receivable from participants	2010-12-31	$28,101
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	$353,855
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$434,113
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,317,202
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,883,089
Total contributions received or receivable from employer(s)	2010-12-31	$58,385
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	$6,228
2009 : CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 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 CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN

2017: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 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 – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
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 – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 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 – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 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 – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K 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	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 funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
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 – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: CENTER FOR PSYCHOLOGICAL SERVICES, LLC 401K PROFIT SHARING PLAN 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 funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

DAX38855

Policy instance

Insurance contract or identification number	DAX38855
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,117
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,117
Insurance broker organization code?	3
Insurance broker name	JEFFREY W DELONE

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

DAX38855

Policy instance

Insurance contract or identification number	DAX38855
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,533
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,533
Insurance broker organization code?	3
Insurance broker name	JEFFREY W DELONE

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

25640

Policy instance

Insurance contract or identification number	25640
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,090
Total amount of fees paid to insurance company	USD $276
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,090
Insurance broker organization code?	3
Amount paid for insurance broker fees	276
Additional information about fees paid to insurance broker	TPA COMPENSATION AND FEES
Insurance broker name	THE MANDMARBLESTONE GROUP LLC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

25640

Policy instance

Insurance contract or identification number	25640
Number of Individuals Covered	7
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,875
Total amount of fees paid to insurance company	USD $212
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,875
Insurance broker organization code?	3
Amount paid for insurance broker fees	212
Additional information about fees paid to insurance broker	TPA COMPENSATION AND FEES
Insurance broker name	THE MANDMARBLESTONE GROUP LLC

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

DAX38855

Policy instance

Insurance contract or identification number	DAX38855
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,333
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,333
Insurance broker organization code?	3
Insurance broker name	JEFFREY W DELONE

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

25640

Policy instance

Insurance contract or identification number	25640
Number of Individuals Covered	6
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,479
Total amount of fees paid to insurance company	USD $184
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,479
Insurance broker organization code?	3
Amount paid for insurance broker fees	184
Additional information about fees paid to insurance broker	TPA COMPENSATION AND FEES
Insurance broker name	THE MANDMARBLESTONE GROUP LLC

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

DAX38855

Policy instance

Insurance contract or identification number	DAX38855
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	JEFFREY W DELONE

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

25640

Policy instance

Insurance contract or identification number	25640
Number of Individuals Covered	6
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,273
Total amount of fees paid to insurance company	USD $571
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

DAX38855

Policy instance

Insurance contract or identification number	DAX38855
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $6,930
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

25640

Policy instance

Insurance contract or identification number	25640
Number of Individuals Covered	6
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $957
Total amount of fees paid to insurance company	USD $120
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

DAX38855

Policy instance

Insurance contract or identification number	DAX38855
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,468
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CENTER FOR PSYCHOLOGICAL SERVICES, LLC
Employer identification number (EIN):	232830593
NAIC Classification:	621330
NAIC Description:	Offices of Mental Health Practitioners (except Physicians)