THE GOOD SAMARITAN HOME, INC. 401k Plan overview

THE GOOD SAMARITAN HOME, INC. Benefits

401k Sponsoring company profile

Company Name:	THE GOOD SAMARITAN HOME, INC.
Employer identification number (EIN):	351065494
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Additional information about THE GOOD SAMARITAN HOME, INC.

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1988-08-03
Company Identification Number:	N27722
Legal Registered Office Address:	13580 S.W. 252 STREET HOMESTEAD 33032

More information about THE GOOD SAMARITAN HOME, INC.

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2009-05-01	BETSY PUTHOFF
502	2009-05-01	BETSY PUTHOFF		BETSY PUTHOFF	2010-09-27
502	2009-05-01	BETSY PUTHOFF		BETSY PUTHOFF	2010-09-27

Form 5500 Responses for THE GOOD SAMARITAN HOME, INC.

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• THE GOOD SAMARITAN HOSPITAL 401(K) RETIREMENT SAVINGS PLAN [EIN = 951656366]
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