401k Plan data: DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN plan

DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN
Plan identification number	001

DAVID M. LUBAR, DDS 401(K) 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.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

DAVID M. LUBAR, DDS has sponsored the creation of one or more 401k plans.

Company Name: DAVID M. LUBAR, DDS

Employer identification number (EIN): 391512807

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 DAVID M. LUBAR, DDS
001 2011-01-01 DAVID M. LUBAR, DDS
001 2009-01-01 DAVID M. LUBAR, DDS

Plan id#	Filing Submission Date	Name of Administrator
001	2013-01-01	DAVID M. LUBAR, DDS
001	2011-01-01	DAVID M. LUBAR, DDS
001	2009-01-01	DAVID M. LUBAR, DDS

Plan Statistics for DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN

Measure Date Value
2013: DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 4
Number of participants with account balances 2013-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2011: DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 5
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 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 5
Number of participants with account balances 2011-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 5
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 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 5
Number of participants with account balances 2009-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2013: DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	4
Number of participants with account balances	2013-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2011: DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	5
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	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	5
Number of participants with account balances	2011-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	5
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	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	5
Number of participants with account balances	2009-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2013 : DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$163,152
Expenses. Total of all expenses incurred	2013-12-31	$531
Benefits paid (including direct rollovers)	2013-12-31	$531
Total plan assets at end of year	2013-12-31	$787,720
Total plan assets at beginning of year	2013-12-31	$625,099
Value of fidelity bond covering the plan	2013-12-31	$65,000
Total contributions received or receivable from participants	2013-12-31	$26,741
Other income received	2013-12-31	$106,565
Net income (gross income less expenses)	2013-12-31	$162,621
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$787,720
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$625,099
Total contributions received or receivable from employer(s)	2013-12-31	$29,846
2011 : DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$66,793
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$526,535
Total plan assets at beginning of year	2011-12-31	$459,742
Value of fidelity bond covering the plan	2011-12-31	$35,000
Total contributions received or receivable from participants	2011-12-31	$24,970
Other income received	2011-12-31	$12,607
Net income (gross income less expenses)	2011-12-31	$66,793
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$526,535
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$459,742
Total contributions received or receivable from employer(s)	2011-12-31	$29,216
2010 : DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$99,095
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$459,742
Total plan assets at beginning of year	2010-12-31	$360,647
Value of fidelity bond covering the plan	2010-12-31	$25,000
Total contributions received or receivable from participants	2010-12-31	$24,606
Other income received	2010-12-31	$45,525
Net income (gross income less expenses)	2010-12-31	$99,095
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$459,742
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$360,647
Total contributions received or receivable from employer(s)	2010-12-31	$28,964

Form 5500 Responses for DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN

2013: DAVID M. LUBAR, DDS 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2011: DAVID M. LUBAR, DDS 401(K) 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
2009: DAVID M. LUBAR, DDS 401(K) 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:	DAVID M. LUBAR, DDS
Employer identification number (EIN):	391512807
NAIC Classification:	621210
NAIC Description:	Offices of Dentists