401k Plan data: BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN plan

BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 401k Plan overview

Plan Name	BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN
Plan identification number	002

BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.

401k Sponsoring company profile

BLOOD BANK OF THE REDWOODS has sponsored the creation of one or more 401k plans.

Company Name: BLOOD BANK OF THE REDWOODS

Employer identification number (EIN): 941231006

NAIC Classification: 621900

Additional information about BLOOD BANK OF THE REDWOODS

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: C0231094

More information about BLOOD BANK OF THE REDWOODS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2011-01-01 CATHERINE SHIMIZU
002 2009-01-01 CATHERINE SHIMIZU
002 2007-01-01 CATHERINE SHIMIZU

Plan id#	Filing Submission Date	Name of Administrator
002	2011-01-01	CATHERINE SHIMIZU
002	2009-01-01	CATHERINE SHIMIZU
002	2007-01-01	CATHERINE SHIMIZU

Plan Statistics for BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN

401k plan membership statisitcs for BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN

Measure Date Value
2011: BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 208
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 0
Total participants 2011-01-01 0
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2009: BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 251
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 117
Number of retired or separated participants receiving benefits 2009-01-01 7
Number of other retired or separated participants entitled to future benefits 2009-01-01 100
Total of all active and inactive participants 2009-01-01 224
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 224
Number of participants with account balances 2009-01-01 187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 9

Measure	Date	Value
2011: BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	208
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	0
Total participants	2011-01-01	0
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2009: BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	251
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	117
Number of retired or separated participants receiving benefits	2009-01-01	7
Number of other retired or separated participants entitled to future benefits	2009-01-01	100
Total of all active and inactive participants	2009-01-01	224
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	224
Number of participants with account balances	2009-01-01	187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	9

Financial Data on BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN

Measure	Date	Value
2011 : BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-10-27	$49,379
Total of all expenses incurred	2011-10-27	$5,247,494
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-10-27	$5,238,721
Value of total corrective distributions	2011-10-27	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-10-27	$203,731
Value of total assets at end of year	2011-10-27	$0
Value of total assets at beginning of year	2011-10-27	$5,198,116
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-10-27	$8,773
Total interest from all sources	2011-10-27	$35,599
Total dividends received (eg from common stock, registered investment company shares)	2011-10-27	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-10-27	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-10-27	$0
Total dividends received from registered investment company shares (eg mutual funds)	2011-10-27	$0
Was this plan covered by a fidelity bond	2011-10-27	No
If this is an individual account plan, was there a blackout period	2011-10-27	No
Were there any nonexempt tranactions with any party-in-interest	2011-10-27	No
Contributions received from participants	2011-10-27	$82,718
Participant contributions at end of year	2011-10-27	$0
Participant contributions at beginning of year	2011-10-27	$158,239
Assets. Other investments not covered elsewhere at end of year	2011-10-27	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-10-27	$137,996
Income. Received or receivable in cash from other sources (including rollovers)	2011-10-27	$79,924
Administrative expenses (other) incurred	2011-10-27	$1,059
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-10-27	No
Income. Non cash contributions	2011-10-27	$0
Value of net income/loss	2011-10-27	$-5,198,115
Value of net assets at end of year (total assets less liabilities)	2011-10-27	$0
Value of net assets at beginning of year (total assets less liabilities)	2011-10-27	$5,198,116
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-10-27	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-10-27	No
Were any leases to which the plan was party in default or uncollectible	2011-10-27	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-10-27	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-10-27	$3,607,538
Interest on participant loans	2011-10-27	$6,524
Interest earned on other investments	2011-10-27	$29,075
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-10-27	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-10-27	$1,133,380
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-10-27	$-189,951
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-10-27	No
Was there a failure to transmit to the plan any participant contributions	2011-10-27	No
Has the plan failed to provide any benefit when due under the plan	2011-10-27	No
Contributions received in cash from employer	2011-10-27	$41,089
Employer contributions (assets) at end of year	2011-10-27	$0
Employer contributions (assets) at beginning of year	2011-10-27	$160,963
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-10-27	$5,238,721
Contract administrator fees	2011-10-27	$7,714
Did the plan have assets held for investment	2011-10-27	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-10-27	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-10-27	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-10-27	Yes
Opinion of an independent qualified public accountant for this plan	2011-10-27	Disclaimer
Accountancy firm name	2011-10-27	ZAINER RINEHART CLARKE, CPAS
Accountancy firm EIN	2011-10-27	942894256
2010 : BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$881,685
Total of all expenses incurred	2010-12-31	$280,622
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$247,491
Expenses. Certain deemed distributions of participant loans	2010-12-31	$25,291
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$363,791
Value of total assets at end of year	2010-12-31	$5,198,116
Value of total assets at beginning of year	2010-12-31	$4,597,053
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$7,840
Total interest from all sources	2010-12-31	$42,192
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$4,335
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$4,335
Was this plan covered by a fidelity bond	2010-12-31	No
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$207,212
Participant contributions at end of year	2010-12-31	$158,239
Participant contributions at beginning of year	2010-12-31	$85,233
Participant contributions at beginning of year	2010-12-31	$9,549
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$137,996
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$99,047
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$2,188
Administrative expenses (other) incurred	2010-12-31	$1,004
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Income. Non cash contributions	2010-12-31	$0
Value of net income/loss	2010-12-31	$601,063
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$5,198,116
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$4,597,053
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$3,607,538
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$2,994,795
Interest on participant loans	2010-12-31	$4,007
Interest earned on other investments	2010-12-31	$38,185
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,133,380
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,103,746
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$471,367
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$154,391
Employer contributions (assets) at end of year	2010-12-31	$160,963
Employer contributions (assets) at beginning of year	2010-12-31	$304,683
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$247,491
Contract administrator fees	2010-12-31	$6,836
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	ZAINER RINEHART CLARKE CPAS
Accountancy firm EIN	2010-12-31	942894256

Form 5500 Responses for BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN

2011: BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	Yes
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2007: BLOOD BANK OF THE REDWOODS TAX-DEFERRED ANNUITY PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	First time form 5500 has been submitted	Yes
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No

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Company Name:	BLOOD BANK OF THE REDWOODS
Employer identification number (EIN):	941231006
NAIC Classification:	621900

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	C0231094