401k Plan data: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT plan

TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 401k Plan overview

Plan Name	TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT
Plan identification number	525

TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

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

Company Name: TRANSPAY, INC.

Employer identification number (EIN): 201019680

NAIC Classification: 541214
NAIC Description: Payroll Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
525 2012-01-01 ELLY PENROD ELLY PENROD 2013-07-17
525 2011-01-01 ELLEN PENROD
525 2010-05-01 ELLEN PENROD

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
525	2012-01-01	ELLY PENROD	ELLY PENROD	2013-07-17
525	2011-01-01	ELLEN PENROD
525	2010-05-01	ELLEN PENROD

Plan Statistics for TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT

401k plan membership statisitcs for TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT

Measure Date Value
2012: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year 2012-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 104
Total of all active and inactive participants 2012-01-01 104
2011: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year 2011-01-01 182
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 222
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 2011-01-01 222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 222
2010: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2010 401k membership
Total participants, beginning-of-year 2010-05-01 168
Total number of active participants reported on line 7a of the Form 5500 2010-05-01 182
Number of retired or separated participants receiving benefits 2010-05-01 0
Number of other retired or separated participants entitled to future benefits 2010-05-01 0
Total of all active and inactive participants 2010-05-01 182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-05-01 0
Total participants 2010-05-01 182

Measure	Date	Value
2012: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year	2012-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	104
Total of all active and inactive participants	2012-01-01	104
2011: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year	2011-01-01	182
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	222
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	222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	222
2010: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2010 401k membership
Total participants, beginning-of-year	2010-05-01	168
Total number of active participants reported on line 7a of the Form 5500	2010-05-01	182
Number of retired or separated participants receiving benefits	2010-05-01	0
Number of other retired or separated participants entitled to future benefits	2010-05-01	0
Total of all active and inactive participants	2010-05-01	182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-05-01	0
Total participants	2010-05-01	182

Form 5500 Responses for TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT

2012: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: TRANSPAY, INC. HEALTH REIMBURSEMENT ARRANGEMENT 2010 form 5500 responses
2010-05-01	Type of plan entity	Single employer plan
2010-05-01	First time form 5500 has been submitted	Yes
2010-05-01	Submission has been amended	No
2010-05-01	This submission is the final filing	No
2010-05-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2010-05-01	Plan is a collectively bargained plan	No
2010-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-05-01	Plan benefit arrangement – General assets of the sponsor	Yes

Potentially related plans

TRANSPAY, INC. 401(K) PROFIT SHARING PLAN [EIN = 800825149]

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Company Name:	TRANSPAY, INC.
Employer identification number (EIN):	201019680
NAIC Classification:	541214
NAIC Description:	Payroll Services