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| Plan Name | CHILES PSYCHOLOGICAL SERVICES SELF EMPLOYED 401(K) |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | CHILES PSYCHOLOGICAL SERVICES INC |
| Employer identification number (EIN): | 201900072 |
| NAIC Classification: | 621330 |
| NAIC Description: | Offices of Mental Health Practitioners (except Physicians) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2021-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2021: CHILES PSYCHOLOGICAL SERVICES SELF EMPLOYED 401(K) 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 1 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 1 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2021-01-01 | 0 |
| Total participants | 2021-01-01 | 1 |
| Number of participants with account balances | 2021-01-01 | 1 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2021-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2021 : CHILES PSYCHOLOGICAL SERVICES SELF EMPLOYED 401(K) 2021 401k financial data | ||
| Total income from all sources | 2021-12-31 | $300,582 |
| Total plan assets at end of year | 2021-12-31 | $300,582 |
| Total plan assets at beginning of year | 2021-12-31 | $0 |
| Total contributions received or receivable from participants | 2021-12-31 | $46,000 |
| Other income received | 2021-12-31 | $9,799 |
| Noncash contributions received | 2021-12-31 | $244,783 |
| Net income (gross income less expenses) | 2021-12-31 | $300,582 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $300,582 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $0 |
| 2021: CHILES PSYCHOLOGICAL SERVICES SELF EMPLOYED 401(K) 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
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