| Plan Name | TAX DEFERRED ANNUITY PLAN OF CROSSROADS COMMUNITY SERVICES, INC. |
| Plan identification number | 003 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | CROSSROADS COMMUNITY SERVICES INC. |
| Employer identification number (EIN): | 237028868 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 003 | 2014-01-01 | MARGARET WENZEL | 2015-05-13 | ||
| 003 | 2013-01-01 | MARGARET WENZEL | 2014-05-13 | ||
| 003 | 2012-01-01 | MARGARET WENZEL | 2013-08-06 | ||
| 003 | 2011-01-01 | MARGARET WENZEL | 2012-05-22 | MARGARET WENZEL | 2012-05-22 |
| 003 | 2010-01-01 | MARGARET WENZEL | 2011-07-19 | MARGARET WENZEL | 2011-07-19 |