401k Plan data: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN plan

DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 401k Plan overview

Plan Name	DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN
Plan identification number	001

DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
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.

401k Sponsoring company profile

DONALD E KOTOSKE has sponsored the creation of one or more 401k plans.

Company Name: DONALD E KOTOSKE

Employer identification number (EIN): 351171865

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 KATHLEEN BRICKLEY 2014-07-18 KATHLEEN BRICKLEY 2014-07-18
001 2012-01-01 KATHLEEN BRICKLEY POAPERS REP 2013-10-29 KATHLEEN BRICKLEY POAPERS REP 2013-10-29
001 2011-01-01 KATHLEEN BRICKLEY POA PERS REP 2014-02-03 KATHLEEN BRICKLEY POA PERS REP 2014-02-03
001 2010-01-01 KATHLEEN BRICKLEY POA PERS REP 2014-02-04 KATHLEEN BRICKLEY POAPERS REP 2014-02-04
001 2009-01-01 KATHLEEN BRICKLEY POAPERS REP 2013-01-28 KATHLEEN BRICKLEY POAPERS REP 2013-01-31
001 2008-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	KATHLEEN BRICKLEY	2014-07-18	KATHLEEN BRICKLEY	2014-07-18
001	2012-01-01	KATHLEEN BRICKLEY POAPERS REP	2013-10-29	KATHLEEN BRICKLEY POAPERS REP	2013-10-29
001	2011-01-01	KATHLEEN BRICKLEY POA PERS REP	2014-02-03	KATHLEEN BRICKLEY POA PERS REP	2014-02-03
001	2010-01-01	KATHLEEN BRICKLEY POA PERS REP	2014-02-04	KATHLEEN BRICKLEY POAPERS REP	2014-02-04
001	2009-01-01	KATHLEEN BRICKLEY POAPERS REP	2013-01-28	KATHLEEN BRICKLEY POAPERS REP	2013-01-31
001	2008-01-01

Plan Statistics for DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN

401k plan membership statisitcs for DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN

Measure Date Value
2013: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
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 0
Total of all active and inactive participants 2013-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 1
Number of participants with account balances 2013-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Total of all active and inactive participants 2012-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1
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 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1
Number of participants with account balances 2011-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1
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 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 1
Number of participants with account balances 2010-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1
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 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1
Number of participants with account balances 2009-01-01 1

Measure	Date	Value
2013: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
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	0
Total of all active and inactive participants	2013-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	1
Number of participants with account balances	2013-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Total of all active and inactive participants	2012-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1
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	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1
Number of participants with account balances	2011-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1
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	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	1
Number of participants with account balances	2010-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1
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	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1
Number of participants with account balances	2009-01-01	1

Financial Data on DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN

Measure	Date	Value
2013 : DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$0
Total plan assets at beginning of year	2013-12-31	$0
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$0
2012 : DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$37,526
Expenses. Total of all expenses incurred	2012-12-31	$793,347
Benefits paid (including direct rollovers)	2012-12-31	$793,347
Total plan assets at end of year	2012-12-31	$0
Total plan assets at beginning of year	2012-12-31	$755,821
Other income received	2012-12-31	$37,526
Net income (gross income less expenses)	2012-12-31	$-755,821
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$755,821
2011 : DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$38,591
Expenses. Total of all expenses incurred	2011-12-31	$110,458
Benefits paid (including direct rollovers)	2011-12-31	$110,458
Total plan assets at end of year	2011-12-31	$755,821
Total plan assets at beginning of year	2011-12-31	$827,688
Other income received	2011-12-31	$38,591
Net income (gross income less expenses)	2011-12-31	$-71,867
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$755,821
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$827,688
2010 : DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$38,963
Expenses. Total of all expenses incurred	2010-12-31	$62,299
Benefits paid (including direct rollovers)	2010-12-31	$62,299
Total plan assets at end of year	2010-12-31	$827,688
Total plan assets at beginning of year	2010-12-31	$851,024
Other income received	2010-12-31	$38,963
Net income (gross income less expenses)	2010-12-31	$-23,336
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$827,688
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$851,024

Form 5500 Responses for DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN

2013: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	This submission is the final filing	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT 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: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT 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: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2008: DONALD E KOTOSKE DO (HR-10) SELF-EMPLOYED RETIREMENT 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:	DONALD E KOTOSKE
Employer identification number (EIN):	351171865