| Plan Name | TAX DEFERRED ANNUITY 403B |
| Plan identification number | 002 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | FORTWOOD CENTER, INC. |
| Employer identification number (EIN): | 620565399 |
| NAIC Classification: | 621420 |
| NAIC Description: | Outpatient Mental Health and Substance Abuse Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 002 | 2013-01-01 | YOLANDA MONFORT | 2014-07-02 | YOLANDA MONFORT | 2014-07-02 |
| 002 | 2012-01-01 | YOLANDA MONFORT | 2013-07-25 | YOLANDA MONFORT | 2013-07-25 |
| 002 | 2011-01-01 | EARL MEDLEY | 2012-09-21 | EARL MEDLEY | 2012-09-21 |
| 002 | 2010-01-01 | EARL MEDLEY | 2011-09-26 | EARL MEDLEY | 2011-09-26 |