401k Plan data: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN plan

FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 401k Plan overview

Plan Name	FAIRMOUNT HOMES EMPLOYEE PENSION PLAN
Plan identification number	001

FAIRMOUNT HOMES EMPLOYEE PENSION PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
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

FAIRMOUNT HOMES has sponsored the creation of one or more 401k plans.

Company Name: FAIRMOUNT HOMES

Employer identification number (EIN): 231680874

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAIRMOUNT HOMES EMPLOYEE PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-07-01 ALLAN CHANKO ALLAN CHANKO 2012-11-15
001 2010-07-01 ALLAN CHANKO ALLAN CHANKO 2012-04-13
001 2009-07-01 ALLAN CHANKO ALLAN CHANKO 2011-03-21

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2011-07-01	ALLAN CHANKO	ALLAN CHANKO	2012-11-15
001	2010-07-01	ALLAN CHANKO	ALLAN CHANKO	2012-04-13
001	2009-07-01	ALLAN CHANKO	ALLAN CHANKO	2011-03-21

Plan Statistics for FAIRMOUNT HOMES EMPLOYEE PENSION PLAN

401k plan membership statisitcs for FAIRMOUNT HOMES EMPLOYEE PENSION PLAN

Measure Date Value
2011: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 167
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 0
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 0
Total of all active and inactive participants 2011-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2010: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 170
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 137
Number of retired or separated participants receiving benefits 2010-07-01 18
Number of other retired or separated participants entitled to future benefits 2010-07-01 11
Total of all active and inactive participants 2010-07-01 166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 1
Total participants 2010-07-01 167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 0
2009: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 171
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 142
Number of retired or separated participants receiving benefits 2009-07-01 15
Number of other retired or separated participants entitled to future benefits 2009-07-01 13
Total of all active and inactive participants 2009-07-01 170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2011: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	167
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	0
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	0
Total of all active and inactive participants	2011-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2010: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	170
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	137
Number of retired or separated participants receiving benefits	2010-07-01	18
Number of other retired or separated participants entitled to future benefits	2010-07-01	11
Total of all active and inactive participants	2010-07-01	166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	1
Total participants	2010-07-01	167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	0
2009: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	171
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	142
Number of retired or separated participants receiving benefits	2009-07-01	15
Number of other retired or separated participants entitled to future benefits	2009-07-01	13
Total of all active and inactive participants	2009-07-01	170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on FAIRMOUNT HOMES EMPLOYEE PENSION PLAN

Measure	Date	Value
2012 : FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-01-04	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-01-04	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-01-04	$0
Total income from all sources (including contributions)	2012-01-04	$344
Total loss/gain on sale of assets	2012-01-04	$0
Total of all expenses incurred	2012-01-04	$4,132,432
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-01-04	$4,109,462
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-01-04	$0
Value of total assets at end of year	2012-01-04	$0
Value of total assets at beginning of year	2012-01-04	$4,132,088
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-01-04	$22,970
Total interest from all sources	2012-01-04	$344
Total dividends received (eg from common stock, registered investment company shares)	2012-01-04	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-01-04	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-01-04	$0
Was this plan covered by a fidelity bond	2012-01-04	Yes
Value of fidelity bond cover	2012-01-04	$250,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-01-04	$0
Were there any nonexempt tranactions with any party-in-interest	2012-01-04	No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-01-04	$2,999,272
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-01-04	$22
Administrative expenses (other) incurred	2012-01-04	$17,231
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-01-04	No
Value of net income/loss	2012-01-04	$-4,132,088
Value of net assets at end of year (total assets less liabilities)	2012-01-04	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-01-04	$4,132,088
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-01-04	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-01-04	No
Were any leases to which the plan was party in default or uncollectible	2012-01-04	No
Investment advisory and management fees	2012-01-04	$5,739
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-01-04	$2,721,941
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-01-04	$2,721,941
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-01-04	$344
Expenses. Payments to insurance carriers foe the provision of benefits	2012-01-04	$1,110,190
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-01-04	No
Was there a failure to transmit to the plan any participant contributions	2012-01-04	No
Has the plan failed to provide any benefit when due under the plan	2012-01-04	No
Employer contributions (assets) at end of year	2012-01-04	$0
Employer contributions (assets) at beginning of year	2012-01-04	$1,410,125
Did the plan have assets held for investment	2012-01-04	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	2012-01-04	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-01-04	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-01-04	Yes
Opinion of an independent qualified public accountant for this plan	2012-01-04	Disclaimer
Accountancy firm name	2012-01-04	PADDEN, GUERRINI & ASSOCIATES, PC
Accountancy firm EIN	2012-01-04	232290841
2011 : FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-06-30	$-36,883
Total unrealized appreciation/depreciation of assets	2011-06-30	$-36,883
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$1,789,019
Total loss/gain on sale of assets	2011-06-30	$310,090
Total of all expenses incurred	2011-06-30	$159,849
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$119,364
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$1,460,125
Value of total assets at end of year	2011-06-30	$4,132,088
Value of total assets at beginning of year	2011-06-30	$2,502,918
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$40,485
Total interest from all sources	2011-06-30	$27,153
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$28,534
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-06-30	$0
Administrative expenses professional fees incurred	2011-06-30	$21,728
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$250,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-06-30	$22
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-06-30	$13,343
Administrative expenses (other) incurred	2011-06-30	$237
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$1,629,170
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$4,132,088
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$2,502,918
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Investment advisory and management fees	2011-06-30	$9,130
Interest earned on other investments	2011-06-30	$-3,129
Income. Interest from US Government securities	2011-06-30	$22,083
Income. Interest from corporate debt instruments	2011-06-30	$8,199
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-06-30	$2,721,941
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-06-30	$241,753
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-06-30	$241,753
Asset value of US Government securities at beginning of year	2011-06-30	$716,840
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$1,460,125
Employer contributions (assets) at end of year	2011-06-30	$1,410,125
Employer contributions (assets) at beginning of year	2011-06-30	$191,000
Income. Dividends from common stock	2011-06-30	$28,534
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$119,364
Asset. Corporate debt instrument preferred debt at beginning of year	2011-06-30	$162,599
Contract administrator fees	2011-06-30	$9,390
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-06-30	$1,177,383
Did the plan have assets held for investment	2011-06-30	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	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Aggregate proceeds on sale of assets	2011-06-30	$4,441,474
Aggregate carrying amount (costs) on sale of assets	2011-06-30	$4,131,384
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	PADDEN, GUERRINI & ASSOCIATES, PC
Accountancy firm EIN	2011-06-30	232290841
2010 : FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for FAIRMOUNT HOMES EMPLOYEE PENSION PLAN

2011: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	Yes
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2010: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2009: FAIRMOUNT HOMES EMPLOYEE PENSION PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

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Company Name:	FAIRMOUNT HOMES
Employer identification number (EIN):	231680874
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities