401k Plan data: JOHN E GOFF MD PC PROFIT SHARING PLAN plan

JOHN E GOFF MD PC PROFIT SHARING PLAN 401k Plan overview

Plan Name	JOHN E GOFF MD PC PROFIT SHARING PLAN
Plan identification number	001

JOHN E GOFF MD PC PROFIT SHARING PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing 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. 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 GOFF MD PC has sponsored the creation of one or more 401k plans.

Company Name: JOHN E GOFF MD PC

Employer identification number (EIN): 431176422

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOHN E GOFF MD PC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 JOHN E GOFF MD JOHN E GOFF MD 2012-06-13
001 2010-01-01 JOHN GOFF JOHN GOFF 2011-07-31
001 2009-01-01 JOHN GOFF JOHN GOFF 2010-06-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2011-01-01	JOHN E GOFF MD	JOHN E GOFF MD	2012-06-13
001	2010-01-01	JOHN GOFF	JOHN GOFF	2011-07-31
001	2009-01-01	JOHN GOFF	JOHN GOFF	2010-06-15

Plan Statistics for JOHN E GOFF MD PC PROFIT SHARING PLAN

401k plan membership statisitcs for JOHN E GOFF MD PC PROFIT SHARING PLAN

Measure Date Value
2011: JOHN E GOFF MD PC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 6
Total of all active and inactive participants 2011-01-01 6
Total participants 2011-01-01 6
Number of participants with account balances 2011-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: JOHN E GOFF MD PC PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 6
Total of all active and inactive participants 2010-01-01 6
Total participants 2010-01-01 6
Number of participants with account balances 2010-01-01 6
2009: JOHN E GOFF MD PC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6
Total of all active and inactive participants 2009-01-01 6
Total participants 2009-01-01 6
Number of participants with account balances 2009-01-01 6

Measure	Date	Value
2011: JOHN E GOFF MD PC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	6
Total of all active and inactive participants	2011-01-01	6
Total participants	2011-01-01	6
Number of participants with account balances	2011-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: JOHN E GOFF MD PC PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	6
Total of all active and inactive participants	2010-01-01	6
Total participants	2010-01-01	6
Number of participants with account balances	2010-01-01	6
2009: JOHN E GOFF MD PC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6
Total of all active and inactive participants	2009-01-01	6
Total participants	2009-01-01	6
Number of participants with account balances	2009-01-01	6

Financial Data on JOHN E GOFF MD PC PROFIT SHARING PLAN

Measure	Date	Value
2011 : JOHN E GOFF MD PC PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$86,966
Expenses. Total of all expenses incurred	2011-12-31	$488
Total plan assets at end of year	2011-12-31	$1,512,607
Total plan assets at beginning of year	2011-12-31	$1,426,129
Value of fidelity bond covering the plan	2011-12-31	$195,000
Other income received	2011-12-31	$52,473
Net income (gross income less expenses)	2011-12-31	$86,478
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,512,607
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,426,129
Total contributions received or receivable from employer(s)	2011-12-31	$34,493
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$488
2010 : JOHN E GOFF MD PC PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$146,145
Expenses. Total of all expenses incurred	2010-12-31	$92
Total plan assets at end of year	2010-12-31	$1,426,129
Total plan assets at beginning of year	2010-12-31	$1,280,076
Value of fidelity bond covering the plan	2010-12-31	$195,000
Other income received	2010-12-31	$109,462
Net income (gross income less expenses)	2010-12-31	$146,053
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,426,129
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,280,076
Total contributions received or receivable from employer(s)	2010-12-31	$36,683
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$92

Form 5500 Responses for JOHN E GOFF MD PC PROFIT SHARING PLAN

2011: JOHN E GOFF MD PC PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: JOHN E GOFF MD PC PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: JOHN E GOFF MD PC PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	JOHN E GOFF MD PC
Employer identification number (EIN):	431176422
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)