|
PRO-CHANGE BEHAVIOR SYSTEMS, INC 401(K) PROFIT SHARING PLAN
|
2012
|
050508853
|
2013-09-13
|
PRO-CHANGE BEHAVIOR SYSTEMS, INC.
|
19
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-04
|
| Business code |
541700
|
| Sponsor’s telephone number |
4013602980
|
| Plan sponsor’s mailing address |
1174 KINGSTOWN ROAD, UNIT 101, SOUTH KINGSTOWN, RI, 02879
|
| Plan sponsor’s
address |
1174 KINGSTOWN ROAD, UNIT 101, SOUTH KINGSTOWN, RI, 02879
|
Plan administrator’s name and address
| Administrator’s EIN |
050508853 |
| Plan administrator’s name |
PRO-CHANGE BEHAVIOR SYSTEMS, INC. |
| Plan administrator’s
address |
1174 KINGSTOWN ROAD, UNIT 101, SOUTH KINGSTOWN, RI, 02879 |
| Administrator’s telephone number |
4013602980 |
Number of participants as of the end of the plan year
| Active participants |
18 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
6 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
24 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2013-09-13 |
| Name of individual signing |
JANICE PROCHASKA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PRO-CHANGE BEHAVIOR SYSTEMS, INC 401(K) PROFIT SHARING PLAN
|
2011
|
050508853
|
2012-06-25
|
PRO-CHANGE BEHAVIOR SYSTEMS, INC.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-04
|
| Business code |
541700
|
| Sponsor’s telephone number |
4018744100
|
| Plan sponsor’s mailing address |
2 CHAFEE, KINGSTON, RI, 02881
|
| Plan sponsor’s
address |
2 CHAFEE, KINGSTON, RI, 02881
|
Plan administrator’s name and address
| Administrator’s EIN |
050508853 |
| Plan administrator’s name |
PRO-CHANGE BEHAVIOR SYSTEMS, INC. |
| Plan administrator’s
address |
2 CHAFEE, KINGSTON, RI, 02881 |
| Administrator’s telephone number |
4018744100 |
Number of participants as of the end of the plan year
| Active participants |
17 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
8 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
24 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
| Role |
Plan administrator |
| Date |
2012-06-25 |
| Name of individual signing |
JANICE PROCHASKA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PRO-CHANGE BEHAVIOR SYSTEMS, INC 401(K) PROFIT SHARING PLAN
|
2010
|
050508853
|
2011-07-26
|
PRO-CHANGE BEHAVIOR SYSTEMS, INC.
|
26
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-04
|
| Business code |
541700
|
| Sponsor’s telephone number |
4018744100
|
| Plan sponsor’s mailing address |
2 CHAFEE, KINGSTON, RI, 02881
|
| Plan sponsor’s
address |
2 CHAFEE, KINGSTON, RI, 02881
|
Plan administrator’s name and address
| Administrator’s EIN |
050508853 |
| Plan administrator’s name |
PRO-CHANGE BEHAVIOR SYSTEMS, INC. |
| Plan administrator’s
address |
2 CHAFEE, KINGSTON, RI, 02881 |
| Administrator’s telephone number |
4018744100 |
Number of participants as of the end of the plan year
| Active participants |
19 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
7 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
25 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
| Role |
Plan administrator |
| Date |
2011-07-26 |
| Name of individual signing |
JANICE PROCHASKA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PRO-CHANGE BEHAVIOR SYSTEMS, INC 401(K) PROFIT SHARING PLAN
|
2009
|
050508853
|
2010-09-07
|
PRO-CHANGE BEHAVIOR SYSTEMS, INC.
|
25
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-04
|
| Business code |
541700
|
| Sponsor’s telephone number |
4018744100
|
| Plan sponsor’s mailing address |
2 CHAFEE, KINGSTON, RI, 02881
|
| Plan sponsor’s
address |
2 CHAFEE, KINGSTON, RI, 02881
|
Plan administrator’s name and address
| Administrator’s EIN |
050508853 |
| Plan administrator’s name |
PRO-CHANGE BEHAVIOR SYSTEMS, INC. |
| Plan administrator’s
address |
2 CHAFEE, KINGSTON, RI, 02881 |
| Administrator’s telephone number |
4018744100 |
Number of participants as of the end of the plan year
| Active participants |
19 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
7 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
24 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-09-07 |
| Name of individual signing |
JANICE PROCHASKA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PRO-CHANGE BEHAVIOR SYSTEMS, INC 401(K) PROFIT SHARING PLAN
|
2009
|
050508853
|
2010-08-20
|
PRO-CHANGE BEHAVIOR SYSTEMS, INC.
|
25
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-04
|
| Business code |
541700
|
| Sponsor’s telephone number |
4018744100
|
| Plan sponsor’s mailing address |
2 CHAFEE, KINGSTON, RI, 02881
|
| Plan sponsor’s
address |
2 CHAFEE, KINGSTON, RI, 02881
|
Plan administrator’s name and address
| Administrator’s EIN |
050508853 |
| Plan administrator’s name |
PRO-CHANGE BEHAVIOR SYSTEMS, INC. |
| Plan administrator’s
address |
2 CHAFEE, KINGSTON, RI, 02881 |
| Administrator’s telephone number |
4018744100 |
Number of participants as of the end of the plan year
| Active participants |
19 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
7 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
24 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Employer/plan sponsor |
| Date |
2010-08-20 |
| Name of individual signing |
JANICE PROCHASKA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
