401k Plan data: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST plan

DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 401k Plan overview

Plan Name	DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST
Plan identification number	001

DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
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.
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

DON R. DEAVER, D.D.S., P.A. has sponsored the creation of one or more 401k plans.

Company Name: DON R. DEAVER, D.D.S., P.A.

Employer identification number (EIN): 464760450

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01
001 2015-01-01

Plan Statistics for DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST

401k plan membership statisitcs for DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST

Measure Date Value
2017: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 2
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 2
Number of participants with account balances 2016-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 1
Number of other retired or separated participants entitled to future benefits 2015-01-01 1
Total of all active and inactive participants 2015-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 2
Number of participants with account balances 2015-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2017: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	2
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	2
Number of participants with account balances	2016-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	1
Number of other retired or separated participants entitled to future benefits	2015-01-01	1
Total of all active and inactive participants	2015-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	2
Number of participants with account balances	2015-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST

Measure	Date	Value
2017 : DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2017 401k financial data
Total income from all sources	2017-12-31	$97,855
Expenses. Total of all expenses incurred	2017-12-31	$1,096,635
Benefits paid (including direct rollovers)	2017-12-31	$1,087,670
Total plan assets at end of year	2017-12-31	$0
Total plan assets at beginning of year	2017-12-31	$998,780
Expenses. Other expenses not covered elsewhere	2017-12-31	$8,965
Other income received	2017-12-31	$97,855
Net income (gross income less expenses)	2017-12-31	$-998,780
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$998,780
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2016 401k financial data
Total income from all sources	2016-12-31	$57,829
Expenses. Total of all expenses incurred	2016-12-31	$49,798
Benefits paid (including direct rollovers)	2016-12-31	$40,575
Total plan assets at end of year	2016-12-31	$998,780
Total plan assets at beginning of year	2016-12-31	$990,749
Other income received	2016-12-31	$57,829
Net income (gross income less expenses)	2016-12-31	$8,031
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$998,780
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$990,749
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$9,223
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2015 401k financial data
Total income from all sources	2015-12-31	$-26,011
Expenses. Total of all expenses incurred	2015-12-31	$42,186
Benefits paid (including direct rollovers)	2015-12-31	$32,550
Total plan assets at end of year	2015-12-31	$990,749
Total plan assets at beginning of year	2015-12-31	$1,058,946
Other income received	2015-12-31	$-26,011
Net income (gross income less expenses)	2015-12-31	$-68,197
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$990,749
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,058,946
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$9,636
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0

Form 5500 Responses for DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST

2017: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: DON R. DEAVER, D.D.S., P.A. RETIREMENT PLAN & TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	DON R. DEAVER, D.D.S., P.A.
Employer identification number (EIN):	464760450
NAIC Classification:	621210
NAIC Description:	Offices of Dentists