THE AUGUST AICHHORN CENTER FOR ADOLESCENT RESIDENTIAL CARE, INC.

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Three-digit plan number (PN)	001
Effective date of plan	1991-07-01
Business code	621420
Sponsor’s telephone number	2128739170
Plan sponsor’s DBA name	AUGUST AICHHORN CENTER
Plan sponsor’s mailing address	15 W 72ND ST APT 1J, NEW YORK, NY, 100233419
Plan sponsor’s address	15 W 72ND ST APT 1J, NEW YORK, NY, 100233419

Plan administrator’s name and address

Administrator’s EIN	133008074
Plan administrator’s name	AUGUST AICHHORN CENTER FOR ADOLESCENT RESIDENTIAL CARE
Plan administrator’s address	15 W 72ND ST APT 1J, NEW YORK, NY, 100233419
Administrator’s telephone number	2128739170

Number of participants as of the end of the plan year

Active participants	118
Retired or separated participants receiving benefits	50
Other retired or separated participants entitled to future benefits	0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2
Number of participants with account balances as of the end of the plan year	157
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	2016-10-05
Name of individual signing	LAURA PAWEL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2016-10-05
Name of individual signing	LAURA PAWEL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1991-07-01
Business code	621420
Sponsor’s telephone number	2128739170
Plan sponsor’s DBA name	AUGUST AICHHORN CENTER
Plan sponsor’s mailing address	15 WEST 72ND STREET, 1J, NEW YORK, NY, 10023
Plan sponsor’s address	15 WEST 72ND STREET, 1J, NEW YORK, NY, 10023

Number of participants as of the end of the plan year

Active participants	285
Retired or separated participants receiving benefits	41
Other retired or separated participants entitled to future benefits	0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2
Number of participants with account balances as of the end of the plan year	322
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	2015-09-18
Name of individual signing	LAURA PAWEL
Valid signature	Filed with authorized/valid electronic signature