401k Plan data: SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN plan

SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	002

SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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.
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.

401k Sponsoring company profile

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

Company Name: SOUTHWORTH INTERNATIONAL, INC.

Employer identification number (EIN): 454067036

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2019-01-01 LYLE COOK 2020-10-09
002 2018-01-01 LYLE COOK 2019-06-21
002 2017-01-01 LYLE COOK 2018-10-12
002 2016-01-01 JOHN SOUTHWORTH 2017-10-11
002 2015-01-01 JOHN SOUTHWORTH
002 2014-01-01 JOHN SOUTHWORTH
002 2013-01-01 JOHN SOUTHWORTH

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2019-01-01	LYLE COOK	2020-10-09
002	2018-01-01	LYLE COOK	2019-06-21
002	2017-01-01	LYLE COOK	2018-10-12
002	2016-01-01	JOHN SOUTHWORTH	2017-10-11
002	2015-01-01	JOHN SOUTHWORTH
002	2014-01-01	JOHN SOUTHWORTH
002	2013-01-01	JOHN SOUTHWORTH

Plan Statistics for SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2015: SOUTHWORTH INTERNATIONAL, INC. 401(K) 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 7
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 0
Total of all active and inactive participants 2015-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 7
Number of participants with account balances 2015-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 9
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 0
Total of all active and inactive participants 2014-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 9
Number of participants with account balances 2014-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2
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 0
Total of all active and inactive participants 2013-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 2
Number of participants with account balances 2013-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0

Measure	Date	Value
2015: SOUTHWORTH INTERNATIONAL, INC. 401(K) 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	7
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	0
Total of all active and inactive participants	2015-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	7
Number of participants with account balances	2015-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	9
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	0
Total of all active and inactive participants	2014-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	9
Number of participants with account balances	2014-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2
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	0
Total of all active and inactive participants	2013-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	2
Number of participants with account balances	2013-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0

Financial Data on SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2015 : SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$28,410
Expenses. Total of all expenses incurred	2015-12-31	$4,532
Benefits paid (including direct rollovers)	2015-12-31	$4,532
Total plan assets at end of year	2015-12-31	$73,832
Total plan assets at beginning of year	2015-12-31	$49,954
Total contributions received or receivable from participants	2015-12-31	$8,979
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	$-1,415
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$23,878
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$73,832
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$49,954
Total contributions received or receivable from employer(s)	2015-12-31	$20,846
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	$0
2014 : SOUTHWORTH INTERNATIONAL, INC. 401(K) 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	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$26,498
Expenses. Total of all expenses incurred	2014-12-31	$10,000
Benefits paid (including direct rollovers)	2014-12-31	$10,000
Total plan assets at end of year	2014-12-31	$49,954
Total plan assets at beginning of year	2014-12-31	$33,456
Total contributions received or receivable from participants	2014-12-31	$0
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	$2,111
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$16,498
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$49,954
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$33,456
Total contributions received or receivable from employer(s)	2014-12-31	$24,387
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	$0
2013 : SOUTHWORTH INTERNATIONAL, INC. 401(K) 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	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$33,456
Expenses. Total of all expenses incurred	2013-12-31	$0
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$33,456
Total plan assets at beginning of year	2013-12-31	$0
Total contributions received or receivable from participants	2013-12-31	$23,000
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	$4,456
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$33,456
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$33,456
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$0
Total contributions received or receivable from employer(s)	2013-12-31	$6,000
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	$0

Form 5500 Responses for SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN

2015: SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: SOUTHWORTH INTERNATIONAL, INC. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	SOUTHWORTH INTERNATIONAL, INC.
Employer identification number (EIN):	454067036
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers