401k Plan data: JOHN E. BUZZELLI PROFIT SHARING PLAN plan

JOHN E. BUZZELLI PROFIT SHARING PLAN 401k Plan overview

Plan Name	JOHN E. BUZZELLI PROFIT SHARING PLAN
Plan identification number	001

JOHN E. BUZZELLI PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
Plan covering Self-Employed individuals.
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.
Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

JOHN E. BUZZELLI has sponsored the creation of one or more 401k plans.

Company Name: JOHN E. BUZZELLI

Employer identification number (EIN): 341753150

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOHN E. BUZZELLI PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 JOHN BUZZELLI 2016-07-26 JOHN BUZZELLI 2016-07-26
001 2015-01-01 JOHN BUZZELLI 2016-07-01 JOHN BUZZELLI 2016-07-01
001 2014-01-01 DR.JOHN E. BUZZELLI 2015-07-16
001 2013-01-01 JOHN BUZZELLI 2014-08-04 JOHN BUZZELLI 2014-08-04
001 2012-01-01 JOHN BUZZELLI 2013-06-11 JOHN BUZZELLI 2013-06-11
001 2011-01-01 JOHN BUZZELLI
001 2010-01-01 JOHN BUZZELLI
001 2009-01-01 JOHN BUZZELLI

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	JOHN BUZZELLI	2016-07-26	JOHN BUZZELLI	2016-07-26
001	2015-01-01	JOHN BUZZELLI	2016-07-01	JOHN BUZZELLI	2016-07-01
001	2014-01-01	DR.JOHN E. BUZZELLI	2015-07-16
001	2013-01-01	JOHN BUZZELLI	2014-08-04	JOHN BUZZELLI	2014-08-04
001	2012-01-01	JOHN BUZZELLI	2013-06-11	JOHN BUZZELLI	2013-06-11
001	2011-01-01	JOHN BUZZELLI
001	2010-01-01	JOHN BUZZELLI
001	2009-01-01	JOHN BUZZELLI

Plan Statistics for JOHN E. BUZZELLI PROFIT SHARING PLAN

401k plan membership statisitcs for JOHN E. BUZZELLI PROFIT SHARING PLAN

Measure Date Value
2011: JOHN E. BUZZELLI PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3
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 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 3
Number of participants with account balances 2011-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: JOHN E. BUZZELLI PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 3
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 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 3
Number of participants with account balances 2010-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: JOHN E. BUZZELLI PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3
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 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 3
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: JOHN E. BUZZELLI PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3
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	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	3
Number of participants with account balances	2011-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: JOHN E. BUZZELLI PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	3
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	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	3
Number of participants with account balances	2010-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: JOHN E. BUZZELLI PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3
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	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	3
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on JOHN E. BUZZELLI PROFIT SHARING PLAN

Measure	Date	Value
2011 : JOHN E. BUZZELLI PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$29,148
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$679,967
Total plan assets at beginning of year	2011-12-31	$650,819
Value of fidelity bond covering the plan	2011-12-31	$70,000
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Other income received	2011-12-31	$1,431
Net income (gross income less expenses)	2011-12-31	$29,148
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$679,967
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$650,819
Total contributions received or receivable from employer(s)	2011-12-31	$27,717
2010 : JOHN E. BUZZELLI PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$112,494
Expenses. Total of all expenses incurred	2010-12-31	$60
Total plan assets at end of year	2010-12-31	$650,819
Total plan assets at beginning of year	2010-12-31	$538,385
Value of fidelity bond covering the plan	2010-12-31	$70,000
Expenses. Other expenses not covered elsewhere	2010-12-31	$60
Other income received	2010-12-31	$84,751
Net income (gross income less expenses)	2010-12-31	$112,434
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$650,819
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$538,385
Total contributions received or receivable from employer(s)	2010-12-31	$27,743

Form 5500 Responses for JOHN E. BUZZELLI PROFIT SHARING PLAN

2011: JOHN E. BUZZELLI PROFIT SHARING 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: JOHN E. BUZZELLI PROFIT SHARING 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: JOHN E. BUZZELLI PROFIT SHARING 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

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Company Name:	JOHN E. BUZZELLI
Employer identification number (EIN):	341753150
NAIC Classification:	621210
NAIC Description:	Offices of Dentists