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| Plan Name | JEWISH HOME ASSISTED LIVING 401(K) PROFIT SHARING PLAN & TRUST |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | JEWISH HOME ASSISTED LIVING |
| Employer identification number (EIN): | 450501306 |
| 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 |
|---|---|---|---|---|---|
| 001 | 2008-01-01 | CHARLES BERKOWITZ | CHARLES BERKOWITZ | 2011-06-29 |
| Measure | Date | Value |
|---|---|---|
| 2008: JEWISH HOME ASSISTED LIVING 401(K) PROFIT SHARING PLAN & TRUST 2008 401k membership | ||
| Total participants, beginning-of-year | 2008-01-01 | 66 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2008-01-01 | 0 |
| Total of all active and inactive participants | 2008-01-01 | 0 |
| Total participants | 2008-01-01 | 0 |
| Number of participants with account balances | 2008-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2008 : JEWISH HOME ASSISTED LIVING 401(K) PROFIT SHARING PLAN & TRUST 2008 401k financial data | ||
| Transfers to/from the plan | 2008-05-15 | $-67,417 |
| Total income from all sources | 2008-05-15 | $39,503 |
| Expenses. Total of all expenses incurred | 2008-05-15 | $3,310 |
| Benefits paid (including direct rollovers) | 2008-05-15 | $3,216 |
| Total plan assets at beginning of year | 2008-05-15 | $31,224 |
| Value of fidelity bond covering the plan | 2008-05-15 | $20,000 |
| Total contributions received or receivable from participants | 2008-05-15 | $17,369 |
| Other income received | 2008-05-15 | $860 |
| Net income (gross income less expenses) | 2008-05-15 | $36,193 |
| Net plan assets at beginning of year (total assets less liabilities) | 2008-05-15 | $31,224 |
| Total contributions received or receivable from employer(s) | 2008-05-15 | $21,274 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2008-05-15 | $94 |
| 2008: JEWISH HOME ASSISTED LIVING 401(K) PROFIT SHARING PLAN & TRUST 2008 form 5500 responses | ||
|---|---|---|
| 2008-01-01 | Type of plan entity | Single employer plan |
| 2008-01-01 | This submission is the final filing | Yes |
| 2008-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2008-01-01 | Plan funding arrangement – Trust | Yes |
| 2008-01-01 | Plan benefit arrangement - Trust | Yes |
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