401k Plan data: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN plan

SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 401k Plan overview

Plan Name	SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN
Plan identification number	002

SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE 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). Plan covering Self-Employed individuals. Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY has sponsored the creation of one or more 401k plans.

Company Name: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY

Employer identification number (EIN): 330866944

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 ANDREW K. CHANG 2013-08-29 ANDREW K. CHANG 2013-08-29
002 2011-01-01 ANDREW K. CHANG ANDREW K. CHANG 2012-06-12
002 2010-01-01 ANDREW K. CHANG ANDREW K. CHANG 2011-05-11
002 2009-01-01 ANDREW K. CHANG ANDREW K. CHANG 2010-09-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2012-01-01	ANDREW K. CHANG	2013-08-29	ANDREW K. CHANG	2013-08-29
002	2011-01-01	ANDREW K. CHANG		ANDREW K. CHANG	2012-06-12
002	2010-01-01	ANDREW K. CHANG		ANDREW K. CHANG	2011-05-11
002	2009-01-01	ANDREW K. CHANG		ANDREW K. CHANG	2010-09-15

Plan Statistics for SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN

401k plan membership statisitcs for SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN

Measure Date Value
2011: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2
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 0
Total of all active and inactive participants 2011-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 2
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 0
Total of all active and inactive participants 2010-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 2
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 0
Total of all active and inactive participants 2009-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 2

Measure	Date	Value
2011: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2
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	0
Total of all active and inactive participants	2011-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	2
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	0
Total of all active and inactive participants	2010-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2
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	0
Total of all active and inactive participants	2009-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	2

Financial Data on SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN

Measure	Date	Value
2011 : SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$242,311
Expenses. Total of all expenses incurred	2011-12-31	$50
Total plan assets at end of year	2011-12-31	$854,541
Total plan assets at beginning of year	2011-12-31	$612,280
Other income received	2011-12-31	$15,119
Net income (gross income less expenses)	2011-12-31	$242,261
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$854,541
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$612,280
Total contributions received or receivable from employer(s)	2011-12-31	$227,192
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$50
2010 : SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$169,238
Expenses. Total of all expenses incurred	2010-12-31	$50
Total plan assets at end of year	2010-12-31	$612,280
Total plan assets at beginning of year	2010-12-31	$443,092
Other income received	2010-12-31	$5,675
Net income (gross income less expenses)	2010-12-31	$169,188
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$612,280
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$443,092
Total contributions received or receivable from employer(s)	2010-12-31	$163,563
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$50

Form 5500 Responses for SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN

2011: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY CASH BALANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	SAN DIEGO CENTER FOR ORAL AND FACIAL SURGERY
Employer identification number (EIN):	330866944
NAIC Classification:	621210
NAIC Description:	Offices of Dentists