401k Plan data: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN plan

ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN 401k Plan overview

Plan Name	ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN
Plan identification number	002

ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING 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.

401k Sponsoring company profile

ROCK VALLEY ANESTHESIOLOGISTS, S.C has sponsored the creation of one or more 401k plans.

Company Name: ROCK VALLEY ANESTHESIOLOGISTS, S.C

Employer identification number (EIN): 363682721

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2013-01-01 HANY AFRAM 2014-09-05 HANY AFRAM 2014-09-05
002 2012-01-01 HANY AFRAM 2013-07-03
002 2011-01-01 HANY M AFRAM
002 2010-01-01 HANY M AFRAM
002 2009-01-01 HANY AFRAM

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2013-01-01	HANY AFRAM	2014-09-05	HANY AFRAM	2014-09-05
002	2012-01-01	HANY AFRAM	2013-07-03
002	2011-01-01	HANY M AFRAM
002	2010-01-01	HANY M AFRAM
002	2009-01-01	HANY AFRAM

Plan Statistics for ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN

401k plan membership statisitcs for ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN

Measure Date Value
2011: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING 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
Total of all active and inactive participants 2011-01-01 2
Total participants 2011-01-01 2
2010: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING 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
Total of all active and inactive participants 2010-01-01 2
Total participants 2010-01-01 2
2009: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2
Total of all active and inactive participants 2009-01-01 0
Total participants 2009-01-01 0

Measure	Date	Value
2011: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING 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
Total of all active and inactive participants	2011-01-01	2
Total participants	2011-01-01	2
2010: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING 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
Total of all active and inactive participants	2010-01-01	2
Total participants	2010-01-01	2
2009: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2
Total of all active and inactive participants	2009-01-01	0
Total participants	2009-01-01	0

Financial Data on ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN

Measure	Date	Value
2011 : ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$-55,193
Total plan assets at end of year	2011-12-31	$172,461
Total plan assets at beginning of year	2011-12-31	$227,654
Other income received	2011-12-31	$-55,193
Net income (gross income less expenses)	2011-12-31	$-55,193
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$172,461
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$227,654
2010 : ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$53,688
Expenses. Total of all expenses incurred	2010-12-31	$50
Total plan assets at end of year	2010-12-31	$227,654
Total plan assets at beginning of year	2010-12-31	$174,016
Expenses. Other expenses not covered elsewhere	2010-12-31	$50
Other income received	2010-12-31	$53,688
Net income (gross income less expenses)	2010-12-31	$53,638
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$227,654
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$174,016

Form 5500 Responses for ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING PLAN

2011: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING 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: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING 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: ROCK VALLEY ANESTHESIOLOGISTS, SC PROFIT SHARING 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

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Company Name:	ROCK VALLEY ANESTHESIOLOGISTS, S.C
Employer identification number (EIN):	363682721
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)