401k Plan data: STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN plan

STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN
Plan identification number	001

STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 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

STEPHEN M. GOLDSTEIN, D.D.S., LTD has sponsored the creation of one or more 401k plans.

Company Name: STEPHEN M. GOLDSTEIN, D.D.S., LTD

Employer identification number (EIN): 541921137

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STEPHEN M. GOLDSTEIN, D.D.S. 401(K) 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 STEPHEN M. GOLDSTEIN, D.D.S. STEPHEN M. GOLDSTEIN, D.D.S. 2011-12-09
001 2010-01-01 STEPHEN M. GOLDSTEIN, D.D.S. STEPHEN M. GOLDSTEIN, D.D.S. 2011-07-12
001 2009-01-01 STEPHEN M. GOLDSTEIN, D.D.S. STEPHEN M. GOLDSTEIN, D.D.S. 2010-09-20
001 2009-01-01 STEPHEN M. GOLDSTEIN, D.D.S. STEPHEN M. GOLDSTEIN, D.D.S. 2010-09-20

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2011-01-01	STEPHEN M. GOLDSTEIN, D.D.S.	STEPHEN M. GOLDSTEIN, D.D.S.	2011-12-09
001	2010-01-01	STEPHEN M. GOLDSTEIN, D.D.S.	STEPHEN M. GOLDSTEIN, D.D.S.	2011-07-12
001	2009-01-01	STEPHEN M. GOLDSTEIN, D.D.S.	STEPHEN M. GOLDSTEIN, D.D.S.	2010-09-20
001	2009-01-01	STEPHEN M. GOLDSTEIN, D.D.S.	STEPHEN M. GOLDSTEIN, D.D.S.	2010-09-20

Plan Statistics for STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN

Measure Date Value
2011: STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 0
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 12
Number of retired or separated participants receiving benefits 2010-01-01 1
Number of other retired or separated participants entitled to future benefits 2010-01-01 3
Total of all active and inactive participants 2010-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 16
Number of participants with account balances 2010-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 13
Number of retired or separated participants receiving benefits 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 2
Total of all active and inactive participants 2009-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 16
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	0
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	12
Number of retired or separated participants receiving benefits	2010-01-01	1
Number of other retired or separated participants entitled to future benefits	2010-01-01	3
Total of all active and inactive participants	2010-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	16
Number of participants with account balances	2010-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	13
Number of retired or separated participants receiving benefits	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	2
Total of all active and inactive participants	2009-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	16
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2011 : STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-10-31	$26,318
Expenses. Total of all expenses incurred	2011-10-31	$1,256,002
Benefits paid (including direct rollovers)	2011-10-31	$1,256,002
Total plan assets at end of year	2011-10-31	$0
Total plan assets at beginning of year	2011-10-31	$1,229,684
Value of fidelity bond covering the plan	2011-10-31	$120,000
Total contributions received or receivable from participants	2011-10-31	$26,822
Other income received	2011-10-31	$-12,777
Net income (gross income less expenses)	2011-10-31	$-1,229,684
Net plan assets at end of year (total assets less liabilities)	2011-10-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2011-10-31	$1,229,684
Total contributions received or receivable from employer(s)	2011-10-31	$12,273
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-10-31	$0
2010 : STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$255,241
Expenses. Total of all expenses incurred	2010-12-31	$7,691
Total plan assets at end of year	2010-12-31	$1,229,684
Total plan assets at beginning of year	2010-12-31	$982,134
Value of fidelity bond covering the plan	2010-12-31	$90,000
Total contributions received or receivable from participants	2010-12-31	$46,123
Expenses. Other expenses not covered elsewhere	2010-12-31	$7,691
Other income received	2010-12-31	$149,405
Net income (gross income less expenses)	2010-12-31	$247,550
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,229,684
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$982,134
Assets. Value of participant loans	2010-12-31	$49,936
Total contributions received or receivable from employer(s)	2010-12-31	$59,713
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN

2011: STEPHEN M. GOLDSTEIN, D.D.S. 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	Yes
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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
2010: STEPHEN M. GOLDSTEIN, D.D.S. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: STEPHEN M. GOLDSTEIN, D.D.S. 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:	STEPHEN M. GOLDSTEIN, D.D.S., LTD
Employer identification number (EIN):	541921137
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)