401k Plan data: ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN plan

ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN
Plan identification number	003

ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
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

ANSONIA WESTFIELD VETERINARY HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: ANSONIA WESTFIELD VETERINARY HOSPITAL

Employer identification number (EIN): 061216773

NAIC Classification: 541940
NAIC Description: Veterinary Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2017-01-01 MANJUNATH SEETHARAMAN MANJUNATH SEETHARAMAN 2018-05-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2017-01-01	MANJUNATH SEETHARAMAN		MANJUNATH SEETHARAMAN	2018-05-17

Plan Statistics for ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN

Measure Date Value
2017: ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 4
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 2
Total of all active and inactive participants 2017-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 6
Number of participants with account balances 2017-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 1

Measure	Date	Value
2017: ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	4
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	2
Total of all active and inactive participants	2017-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	6
Number of participants with account balances	2017-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	1

Financial Data on ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2017 : ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$1,370,163
Expenses. Total of all expenses incurred	2017-12-31	$30,436
Benefits paid (including direct rollovers)	2017-12-31	$18,993
Total plan assets at end of year	2017-12-31	$1,339,727
Total plan assets at beginning of year	2017-12-31	$0
Total contributions received or receivable from participants	2017-12-31	$24,000
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$1,289,487
Other income received	2017-12-31	$29,007
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$1,339,727
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$1,339,727
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$27,669
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$11,443
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0

Form 5500 Responses for ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN

2017: ANSONIA WESTFIELD VETERINARY HOSPITAL 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

128357

Policy instance

Insurance contract or identification number	128357
Number of Individuals Covered	6
Insurance policy start date	2017-02-28
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,063
Total amount of fees paid to insurance company	USD $0
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,063
Insurance broker organization code?	3
Insurance broker name	EDWARD D. JONES AND CO. L.P.

Potentially related plans

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Company Name:	ANSONIA WESTFIELD VETERINARY HOSPITAL
Employer identification number (EIN):	061216773
NAIC Classification:	541940
NAIC Description:	Veterinary Services