401k Plan data: COLLISION CURE, INC. 401(K) SAVINGS PLAN plan

COLLISION CURE, INC. 401(K) SAVINGS PLAN 401k Plan overview

Plan Name	COLLISION CURE, INC. 401(K) SAVINGS PLAN
Plan identification number	001

COLLISION CURE, INC. 401(K) 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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

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

Company Name: COLLISION CURE, INC.

Employer identification number (EIN): 412070375

NAIC Classification: 441300
NAIC Description: Automotive Parts, Accessories, and Tire Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLLISION CURE, INC. 401(K) SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 LYNN FIELDS 2017-09-18 LYNN FIELDS 2017-09-18
001 2015-01-01 LYNN FIELDS 2016-08-09 LYNN FIELDS 2016-08-09
001 2014-01-01 L. LYNN FIELDS 2015-08-04 L. LYNN FIELDS 2015-08-04
001 2013-01-01 LYNN FIELDS 2014-09-30 LYNN FIELDS 2014-09-30
001 2012-01-01 L. LYNN FIELDS
001 2011-01-01 L. LYNN FIELDS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	LYNN FIELDS	2017-09-18	LYNN FIELDS	2017-09-18
001	2015-01-01	LYNN FIELDS	2016-08-09	LYNN FIELDS	2016-08-09
001	2014-01-01	L. LYNN FIELDS	2015-08-04	L. LYNN FIELDS	2015-08-04
001	2013-01-01	LYNN FIELDS	2014-09-30	LYNN FIELDS	2014-09-30
001	2012-01-01	L. LYNN FIELDS
001	2011-01-01	L. LYNN FIELDS

Plan Statistics for COLLISION CURE, INC. 401(K) SAVINGS PLAN

401k plan membership statisitcs for COLLISION CURE, INC. 401(K) SAVINGS PLAN

Measure Date Value
2012: COLLISION CURE, INC. 401(K) SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 44
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 49
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 4
Total of all active and inactive participants 2012-01-01 53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 53
Number of participants with account balances 2012-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: COLLISION CURE, INC. 401(K) SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 41
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 3
Total of all active and inactive participants 2011-01-01 44
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 44
Number of participants with account balances 2011-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2012: COLLISION CURE, INC. 401(K) SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	44
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	49
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	4
Total of all active and inactive participants	2012-01-01	53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	53
Number of participants with account balances	2012-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: COLLISION CURE, INC. 401(K) SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	41
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	3
Total of all active and inactive participants	2011-01-01	44
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	44
Number of participants with account balances	2011-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on COLLISION CURE, INC. 401(K) SAVINGS PLAN

Measure	Date	Value
2012 : COLLISION CURE, INC. 401(K) SAVINGS PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$66,471
Expenses. Total of all expenses incurred	2012-12-31	$35,156
Benefits paid (including direct rollovers)	2012-12-31	$35,156
Total plan assets at end of year	2012-12-31	$193,154
Total plan assets at beginning of year	2012-12-31	$161,839
Value of fidelity bond covering the plan	2012-12-31	$25,000
Total contributions received or receivable from participants	2012-12-31	$50,725
Other income received	2012-12-31	$15,746
Net income (gross income less expenses)	2012-12-31	$31,315
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$193,154
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$161,839
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : COLLISION CURE, INC. 401(K) SAVINGS PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$39,677
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$161,839
Total plan assets at beginning of year	2011-12-31	$122,162
Value of fidelity bond covering the plan	2011-12-31	$10,000
Total contributions received or receivable from participants	2011-12-31	$46,092
Contributions received from other sources (not participants or employers)	2011-12-31	$1,185
Other income received	2011-12-31	$-7,600
Net income (gross income less expenses)	2011-12-31	$39,677
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$161,839
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$122,162
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : COLLISION CURE, INC. 401(K) SAVINGS PLAN 2010 401k financial data
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$34,342
Expenses. Total of all expenses incurred	2010-12-31	$5,322
Benefits paid (including direct rollovers)	2010-12-31	$5,322
Total plan assets at end of year	2010-12-31	$122,162
Total plan assets at beginning of year	2010-12-31	$93,142
Value of fidelity bond covering the plan	2010-12-31	$10,000
Total contributions received or receivable from participants	2010-12-31	$21,017
Other income received	2010-12-31	$13,325
Net income (gross income less expenses)	2010-12-31	$29,020
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$122,162
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$93,142
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for COLLISION CURE, INC. 401(K) SAVINGS PLAN

2012: COLLISION CURE, INC. 401(K) SAVINGS PLAN 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COLLISION CURE, INC. 401(K) SAVINGS PLAN 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	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

48597

Policy instance

Insurance contract or identification number	48597
Number of Individuals Covered	41
Insurance policy start date	2009-01-01
Insurance policy end date	2009-12-31
Total amount of commissions paid to insurance broker	USD $539,547
Total amount of fees paid to insurance company	USD $27
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $539,547
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	FACTS, INC.

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Company Name:	COLLISION CURE, INC.
Employer identification number (EIN):	412070375
NAIC Classification:	441300
NAIC Description:	Automotive Parts, Accessories, and Tire Stores