401k Plan data: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN plan

BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 401k Plan overview

Plan Name	BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN
Plan identification number	003

BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	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.

401k Sponsoring company profile

BEVERLY A. JOHNSON, M.D.,P.C. has sponsored the creation of one or more 401k plans.

Company Name: BEVERLY A. JOHNSON, M.D.,P.C.

Employer identification number (EIN): 521974148

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2012-01-01 BEVERLY A. JOHNSON
003 2011-01-01 BEVERLY A. JOHNSON
003 2010-01-01 BEVERLY A. JOHNSON BEVERLY A. JOHNSON 2011-06-23
003 2009-01-01 BEVERLY A JOHNSON BEVERLY A. JOHNSON 2010-09-26

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2012-01-01	BEVERLY A. JOHNSON
003	2011-01-01	BEVERLY A. JOHNSON
003	2010-01-01	BEVERLY A. JOHNSON	BEVERLY A. JOHNSON	2011-06-23
003	2009-01-01	BEVERLY A JOHNSON	BEVERLY A. JOHNSON	2010-09-26

Plan Statistics for BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN

401k plan membership statisitcs for BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN

Measure Date Value
2012: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1
Total of all active and inactive participants 2012-01-01 1
Total participants 2012-01-01 1
Number of participants with account balances 2012-01-01 1
2011: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1
Total of all active and inactive participants 2011-01-01 1
Total participants 2011-01-01 1
Number of participants with account balances 2011-01-01 4
2010: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1
Total of all active and inactive participants 2010-01-01 1
Total participants 2010-01-01 1
Number of participants with account balances 2010-01-01 4
2009: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1
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 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1
Number of participants with account balances 2009-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1
Total of all active and inactive participants	2012-01-01	1
Total participants	2012-01-01	1
Number of participants with account balances	2012-01-01	1
2011: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1
Total of all active and inactive participants	2011-01-01	1
Total participants	2011-01-01	1
Number of participants with account balances	2011-01-01	4
2010: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1
Total of all active and inactive participants	2010-01-01	1
Total participants	2010-01-01	1
Number of participants with account balances	2010-01-01	4
2009: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1
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	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1
Number of participants with account balances	2009-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN

Measure	Date	Value
2013 : BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-06-30	$827
Expenses. Total of all expenses incurred	2013-06-30	$104,761
Benefits paid (including direct rollovers)	2013-06-30	$104,600
Total plan assets at end of year	2013-06-30	$0
Total plan assets at beginning of year	2013-06-30	$103,934
Value of fidelity bond covering the plan	2013-06-30	$50,000
Expenses. Other expenses not covered elsewhere	2013-06-30	$1
Other income received	2013-06-30	$827
Net income (gross income less expenses)	2013-06-30	$-103,934
Net plan assets at end of year (total assets less liabilities)	2013-06-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-06-30	$103,934
Expenses. Administrative service providers (salaries,fees and commissions)	2013-06-30	$160
2012 : BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$5,924
Expenses. Total of all expenses incurred	2012-12-31	$17,272
Benefits paid (including direct rollovers)	2012-12-31	$15,852
Total plan assets at end of year	2012-12-31	$103,934
Total plan assets at beginning of year	2012-12-31	$115,282
Value of fidelity bond covering the plan	2012-12-31	$50,000
Expenses. Other expenses not covered elsewhere	2012-12-31	$58
Other income received	2012-12-31	$5,924
Net income (gross income less expenses)	2012-12-31	$-11,348
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$103,934
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$115,282
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$1,362
2011 : BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$-8,350
Expenses. Total of all expenses incurred	2011-12-31	$1,771
Total plan assets at end of year	2011-12-31	$115,282
Total plan assets at beginning of year	2011-12-31	$125,403
Value of fidelity bond covering the plan	2011-12-31	$50,000
Expenses. Other expenses not covered elsewhere	2011-12-31	$167
Other income received	2011-12-31	$-8,350
Net income (gross income less expenses)	2011-12-31	$-10,121
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$115,282
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$125,403
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$1,604
2010 : BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$10,089
Expenses. Total of all expenses incurred	2010-12-31	$1,892
Total plan assets at end of year	2010-12-31	$125,403
Total plan assets at beginning of year	2010-12-31	$117,206
Value of fidelity bond covering the plan	2010-12-31	$20,000
Expenses. Other expenses not covered elsewhere	2010-12-31	$193
Other income received	2010-12-31	$10,089
Net income (gross income less expenses)	2010-12-31	$8,197
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$125,403
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$117,206
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$1,699

Form 5500 Responses for BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN

2012: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) 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: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) 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: BEVERLY A. JOHNSON, M.D.,P.C. 401(K) 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:	BEVERLY A. JOHNSON, M.D.,P.C.
Employer identification number (EIN):	521974148
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)