401k Plan data: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN plan

ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 401k Plan overview

Plan Name	ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN
Plan identification number	002

ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing

401k Sponsoring company profile

ROBERT G. LEE MD, P.C. has sponsored the creation of one or more 401k plans.

Company Name: ROBERT G. LEE MD, P.C.

Employer identification number (EIN): 382074368

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-07-01 DAVID GWIZDALA 2016-11-15 DAVID GWIZDALA 2016-11-15
002 2014-07-01 DAVID GWIZDALA 2015-11-30 DAVID GWIZDALA 2015-11-30
002 2013-07-01 DAVID GWIZDALA 2014-11-07 DAVID GWIZDALA 2014-11-07
002 2012-07-01 DAVID GWIZDALA 2014-01-02 DAVID GWIZDALA 2014-01-02
002 2011-07-01 DAVID GWIZDALA 2012-12-16 DAVID GWIZDALA 2012-12-16
002 2009-07-01 DAVID GWIZDALA 2011-03-23 DAVID GWIZDALA 2011-03-23
002 2009-07-01 DAVID GWIZDALA 2011-03-24 DAVID GWIZDALA 2011-03-24

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2015-07-01	DAVID GWIZDALA	2016-11-15	DAVID GWIZDALA	2016-11-15
002	2014-07-01	DAVID GWIZDALA	2015-11-30	DAVID GWIZDALA	2015-11-30
002	2013-07-01	DAVID GWIZDALA	2014-11-07	DAVID GWIZDALA	2014-11-07
002	2012-07-01	DAVID GWIZDALA	2014-01-02	DAVID GWIZDALA	2014-01-02
002	2011-07-01	DAVID GWIZDALA	2012-12-16	DAVID GWIZDALA	2012-12-16
002	2009-07-01	DAVID GWIZDALA	2011-03-23	DAVID GWIZDALA	2011-03-23
002	2009-07-01	DAVID GWIZDALA	2011-03-24	DAVID GWIZDALA	2011-03-24

Plan Statistics for ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN

401k plan membership statisitcs for ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN

Measure Date Value
2015: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 1
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 0
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 0
Number of participants with account balances 2015-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 1
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 1
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 1
Number of participants with account balances 2014-07-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 1
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 1
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 1
Number of participants with account balances 2013-07-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 1
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 1
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 0
Total of all active and inactive participants 2012-07-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 1
Number of participants with account balances 2012-07-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
2011: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 1
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 1
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 0
Total of all active and inactive participants 2011-07-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 1
Number of participants with account balances 2011-07-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2009: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 1
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 1
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 0
Total of all active and inactive participants 2009-07-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 1
Number of participants with account balances 2009-07-01 1

Measure	Date	Value
2015: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	1
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	0
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	0
Number of participants with account balances	2015-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	1
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	1
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	1
Number of participants with account balances	2014-07-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	1
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	1
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	1
Number of participants with account balances	2013-07-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	1
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	1
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	0
Total of all active and inactive participants	2012-07-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	1
Number of participants with account balances	2012-07-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
2011: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	1
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	1
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	0
Total of all active and inactive participants	2011-07-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	1
Number of participants with account balances	2011-07-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2009: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	1
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	1
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	0
Total of all active and inactive participants	2009-07-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	1
Number of participants with account balances	2009-07-01	1

Financial Data on ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN

Measure	Date	Value
2016 : ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2016 401k financial data
Total income from all sources	2016-06-30	$-11,103
Expenses. Total of all expenses incurred	2016-06-30	$402,448
Benefits paid (including direct rollovers)	2016-06-30	$402,448
Total plan assets at end of year	2016-06-30	$0
Total plan assets at beginning of year	2016-06-30	$413,551
Value of fidelity bond covering the plan	2016-06-30	$100,000
Other income received	2016-06-30	$-11,103
Net income (gross income less expenses)	2016-06-30	$-413,551
Net plan assets at end of year (total assets less liabilities)	2016-06-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2016-06-30	$413,551
2015 : ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2015 401k financial data
Total income from all sources	2015-06-30	$12,836
Expenses. Total of all expenses incurred	2015-06-30	$15,000
Benefits paid (including direct rollovers)	2015-06-30	$15,000
Total plan assets at end of year	2015-06-30	$413,551
Total plan assets at beginning of year	2015-06-30	$415,715
Value of fidelity bond covering the plan	2015-06-30	$100,000
Other income received	2015-06-30	$12,836
Net income (gross income less expenses)	2015-06-30	$-2,164
Net plan assets at end of year (total assets less liabilities)	2015-06-30	$413,551
Net plan assets at beginning of year (total assets less liabilities)	2015-06-30	$415,715
2014 : ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2014 401k financial data
Total income from all sources	2014-06-30	$57,357
Expenses. Total of all expenses incurred	2014-06-30	$13,928
Benefits paid (including direct rollovers)	2014-06-30	$13,928
Total plan assets at end of year	2014-06-30	$415,715
Total plan assets at beginning of year	2014-06-30	$372,286
Value of fidelity bond covering the plan	2014-06-30	$100,000
Other income received	2014-06-30	$57,357
Net income (gross income less expenses)	2014-06-30	$43,429
Net plan assets at end of year (total assets less liabilities)	2014-06-30	$415,715
Net plan assets at beginning of year (total assets less liabilities)	2014-06-30	$372,286
2013 : ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2013 401k financial data
Total income from all sources	2013-06-30	$38,695
Total plan assets at end of year	2013-06-30	$372,286
Total plan assets at beginning of year	2013-06-30	$333,591
Value of fidelity bond covering the plan	2013-06-30	$100,000
Other income received	2013-06-30	$38,695
Net income (gross income less expenses)	2013-06-30	$38,695
Net plan assets at end of year (total assets less liabilities)	2013-06-30	$372,286
Net plan assets at beginning of year (total assets less liabilities)	2013-06-30	$333,591
2012 : ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2012 401k financial data
Total income from all sources	2012-06-30	$6,070
Total plan assets at end of year	2012-06-30	$333,591
Total plan assets at beginning of year	2012-06-30	$327,521
Other income received	2012-06-30	$6,070
Net income (gross income less expenses)	2012-06-30	$6,070
Net plan assets at end of year (total assets less liabilities)	2012-06-30	$333,591
Net plan assets at beginning of year (total assets less liabilities)	2012-06-30	$327,521
2011 : ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-06-30	$46,712
Total plan assets at end of year	2011-06-30	$327,521
Total plan assets at beginning of year	2011-06-30	$280,809
Value of fidelity bond covering the plan	2011-06-30	$100,000
Other income received	2011-06-30	$46,712
Net income (gross income less expenses)	2011-06-30	$46,712
Net plan assets at end of year (total assets less liabilities)	2011-06-30	$327,521
Net plan assets at beginning of year (total assets less liabilities)	2011-06-30	$280,809

Form 5500 Responses for ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN

2015: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	This submission is the final filing	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: ROBERT G. LEE, M.D. P.C. DEFINED CONTRIBUTION RETIREMENT PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

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Company Name:	ROBERT G. LEE MD, P.C.
Employer identification number (EIN):	382074368
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)