401k Plan data: THE 14TH STREET CLINIC SALARY SAVINGS PLAN plan

THE 14TH STREET CLINIC SALARY SAVINGS PLAN 401k Plan overview

Plan Name	THE 14TH STREET CLINIC SALARY SAVINGS PLAN
Plan identification number	001

THE 14TH STREET CLINIC SALARY SAVINGS 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.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
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.
Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

THE 14TH STREET CLINIC has sponsored the creation of one or more 401k plans.

Company Name: THE 14TH STREET CLINIC

Employer identification number (EIN): 942605360

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE 14TH STREET CLINIC SALARY SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2008-01-01 JOAN ZWEBEN 2010-08-12
001 2008-01-01 JOAN ZWEBEN
001 2007-01-01 JOAN ZWEBEN
001 2006-01-01 JOAN ZWEBEN

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2008-01-01		JOAN ZWEBEN	2010-08-12
001	2008-01-01	JOAN ZWEBEN
001	2007-01-01	JOAN ZWEBEN
001	2006-01-01	JOAN ZWEBEN

Plan Statistics for THE 14TH STREET CLINIC SALARY SAVINGS PLAN

401k plan membership statisitcs for THE 14TH STREET CLINIC SALARY SAVINGS PLAN

Measure Date Value
2008: THE 14TH STREET CLINIC SALARY SAVINGS PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 2
2007: THE 14TH STREET CLINIC SALARY SAVINGS PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 29
Number of other retired or separated participants entitled to future benefits 2007-01-01 1
Total of all active and inactive participants 2007-01-01 30
Total participants 2007-01-01 30
Number of participants with account balances 2007-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 1
2006: THE 14TH STREET CLINIC SALARY SAVINGS PLAN 2006 401k membership
Total participants, beginning-of-year 2006-01-01 38
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 29
Number of other retired or separated participants entitled to future benefits 2006-01-01 1
Total of all active and inactive participants 2006-01-01 30
Total participants 2006-01-01 30
Number of participants with account balances 2006-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2006-01-01 6

Measure	Date	Value
2008: THE 14TH STREET CLINIC SALARY SAVINGS PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	2
2007: THE 14TH STREET CLINIC SALARY SAVINGS PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	29
Number of other retired or separated participants entitled to future benefits	2007-01-01	1
Total of all active and inactive participants	2007-01-01	30
Total participants	2007-01-01	30
Number of participants with account balances	2007-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	1
2006: THE 14TH STREET CLINIC SALARY SAVINGS PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	38
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	29
Number of other retired or separated participants entitled to future benefits	2006-01-01	1
Total of all active and inactive participants	2006-01-01	30
Total participants	2006-01-01	30
Number of participants with account balances	2006-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2006-01-01	6

Form 5500 Responses for THE 14TH STREET CLINIC SALARY SAVINGS PLAN

2008: THE 14TH STREET CLINIC SALARY SAVINGS PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
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 is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes
2007: THE 14TH STREET CLINIC SALARY SAVINGS PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
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
2007-01-01	Plan funding arrangement – Insurance	Yes
2007-01-01	Plan benefit arrangement – Insurance	Yes
2006: THE 14TH STREET CLINIC SALARY SAVINGS PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Submission has been amended	No
2006-01-01	This submission is the final filing	No
2006-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-01-01	Plan is a collectively bargained plan	No
2006-01-01	Plan funding arrangement – Insurance	Yes
2006-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	THE 14TH STREET CLINIC
Employer identification number (EIN):	942605360
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers