401k Plan data: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN plan

DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 401k Plan overview

Plan Name	DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN
Plan identification number	001

DAVID JACOBS, M.D. PROFIT SHARING PENSION 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.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
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

DAVID JACOBS, M.D. CENTER FOR PHYSICAL MEDICINE & REHAB, P.C. has sponsored the creation of one or more 401k plans.

Company Name: DAVID JACOBS, M.D. CENTER FOR PHYSICAL MEDICINE & REHAB, P.C.

Employer identification number (EIN): 114508671

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01 DAVID JACOBS 2016-07-08
001 2014-01-01 DAVID JACOBS 2015-10-14
001 2013-01-01 DAVID JACOBS DAVID JACOBS 2014-07-06
001 2012-01-01 DAVID JACOBS DAVID JACOBS 2013-05-17
001 2011-01-01 DAVID JACOBS DAVID JACOBS 2012-10-15
001 2010-01-01 DAVID JACOBS
001 2009-01-01 DAVID JACOBS
001 2008-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01	DAVID JACOBS	2016-07-08
001	2014-01-01	DAVID JACOBS	2015-10-14
001	2013-01-01	DAVID JACOBS		DAVID JACOBS	2014-07-06
001	2012-01-01	DAVID JACOBS		DAVID JACOBS	2013-05-17
001	2011-01-01	DAVID JACOBS		DAVID JACOBS	2012-10-15
001	2010-01-01	DAVID JACOBS
001	2009-01-01	DAVID JACOBS
001	2008-01-01

Plan Statistics for DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN

401k plan membership statisitcs for DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN

Measure Date Value
2013: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 6
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 7
Total of all active and inactive participants 2013-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 13
Number of participants with account balances 2013-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 6
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 7
Total of all active and inactive participants 2012-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 13
Number of participants with account balances 2012-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2
2011: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 10
Number of other retired or separated participants entitled to future benefits 2011-01-01 4
Total of all active and inactive participants 2011-01-01 14
Total participants 2011-01-01 14
Number of participants with account balances 2011-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 10
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 4
Total of all active and inactive participants 2010-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 14
Number of participants with account balances 2010-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 10
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 4
Total of all active and inactive participants 2009-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 14
Number of participants with account balances 2009-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2013: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	6
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	7
Total of all active and inactive participants	2013-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	13
Number of participants with account balances	2013-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	6
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	7
Total of all active and inactive participants	2012-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	13
Number of participants with account balances	2012-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	10
Number of other retired or separated participants entitled to future benefits	2011-01-01	4
Total of all active and inactive participants	2011-01-01	14
Total participants	2011-01-01	14
Number of participants with account balances	2011-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	10
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	4
Total of all active and inactive participants	2010-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	14
Number of participants with account balances	2010-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	10
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	4
Total of all active and inactive participants	2009-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	14
Number of participants with account balances	2009-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN

Measure	Date	Value
2013 : DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$489,905
Expenses. Total of all expenses incurred	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$2,269,034
Total plan assets at beginning of year	2013-12-31	$1,779,129
Value of fidelity bond covering the plan	2013-12-31	$20,000
Other income received	2013-12-31	$489,905
Net income (gross income less expenses)	2013-12-31	$489,905
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,269,034
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,779,129
2012 : DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$194,276
Expenses. Total of all expenses incurred	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$1,779,129
Total plan assets at beginning of year	2012-12-31	$1,584,853
Value of fidelity bond covering the plan	2012-12-31	$20,000
Other income received	2012-12-31	$194,276
Net income (gross income less expenses)	2012-12-31	$194,276
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,779,129
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,584,853
2011 : DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$-18,622
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$1,584,853
Total plan assets at beginning of year	2011-12-31	$1,603,475
Value of fidelity bond covering the plan	2011-12-31	$20,000
Other income received	2011-12-31	$-18,622
Net income (gross income less expenses)	2011-12-31	$-18,622
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,584,853
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,603,475
Total contributions received or receivable from employer(s)	2011-12-31	$0
2010 : DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$246,768
Total plan assets at end of year	2010-12-31	$1,603,475
Total plan assets at beginning of year	2010-12-31	$1,356,707
Value of fidelity bond covering the plan	2010-12-31	$20,000
Other income received	2010-12-31	$151,631
Net income (gross income less expenses)	2010-12-31	$246,768
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,603,475
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,356,707
Total contributions received or receivable from employer(s)	2010-12-31	$95,137
2009 : DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN

2013: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: DAVID JACOBS, M.D. PROFIT SHARING PENSION 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: DAVID JACOBS, M.D. PROFIT SHARING PENSION 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2008: DAVID JACOBS, M.D. PROFIT SHARING PENSION PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No

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Company Name:	DAVID JACOBS, M.D. CENTER FOR PHYSICAL MEDICINE & REHAB, P.C.
Employer identification number (EIN):	114508671
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)