401k Plan data: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST plan

BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan Name	BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST
Plan identification number	001

BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 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

BRUCE E. BOSSE, M.D., P.C. has sponsored the creation of one or more 401k plans.

Company Name: BRUCE E. BOSSE, M.D., P.C.

Employer identification number (EIN): 582082912

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 BRUCE BOSSE 2013-10-14 BRUCE BOSSE 2013-10-14
001 2012-01-01 BRUCE E. BOSSE, MD 2013-10-14 BRUCE E. BOSSE, MD 2013-10-14
001 2011-01-01 BRUCE E. BOSSE, MD BRUCE E. BOSSE, MD 2012-10-03
001 2010-01-01 BRUCE E. BOSSE, MD BRUCE E. BOSSE, MD 2012-10-03
001 2009-01-01 BRUCE E. BOSSE, MD BRUCE E. BOSSE, MD 2012-10-03
001 2008-01-01 BRUCE E. BOSSE, MD BRUCE E. BOSSE, MD 2012-10-03

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	BRUCE BOSSE	2013-10-14	BRUCE BOSSE	2013-10-14
001	2012-01-01	BRUCE E. BOSSE, MD	2013-10-14	BRUCE E. BOSSE, MD	2013-10-14
001	2011-01-01	BRUCE E. BOSSE, MD		BRUCE E. BOSSE, MD	2012-10-03
001	2010-01-01	BRUCE E. BOSSE, MD		BRUCE E. BOSSE, MD	2012-10-03
001	2009-01-01	BRUCE E. BOSSE, MD		BRUCE E. BOSSE, MD	2012-10-03
001	2008-01-01	BRUCE E. BOSSE, MD		BRUCE E. BOSSE, MD	2012-10-03

Plan Statistics for BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST

Measure Date Value
2011: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 4
Number of participants with account balances 2011-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 4
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 4
Number of participants with account balances 2010-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 4
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
2008: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2008 401k membership
Total participants, beginning-of-year 2008-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 4
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 4
Number of participants with account balances 2008-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0

Measure	Date	Value
2011: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	4
Number of participants with account balances	2011-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	4
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	4
Number of participants with account balances	2010-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	4
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
2008: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2008 401k membership
Total participants, beginning-of-year	2008-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	4
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	4
Number of participants with account balances	2008-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0

Financial Data on BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST

Measure	Date	Value
2011 : BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$735
Total plan liabilities at beginning of year	2011-12-31	$735
Total income from all sources	2011-12-31	$34,100
Total plan assets at end of year	2011-12-31	$296,105
Total plan assets at beginning of year	2011-12-31	$262,005
Value of fidelity bond covering the plan	2011-12-31	$30,000
Other income received	2011-12-31	$34,100
Net income (gross income less expenses)	2011-12-31	$34,100
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$295,370
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$261,270
2010 : BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$735
Total plan liabilities at beginning of year	2010-12-31	$735
Total income from all sources	2010-12-31	$19,034
Total plan assets at end of year	2010-12-31	$262,005
Total plan assets at beginning of year	2010-12-31	$242,971
Value of fidelity bond covering the plan	2010-12-31	$30,000
Other income received	2010-12-31	$19,034
Net income (gross income less expenses)	2010-12-31	$19,034
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$261,270
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$242,236
2009 : BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2009 401k financial data
Total plan liabilities at end of year	2009-12-31	$735
Total plan liabilities at beginning of year	2009-12-31	$735
Total income from all sources	2009-12-31	$20,860
Expenses. Total of all expenses incurred	2009-12-31	$44
Total plan assets at end of year	2009-12-31	$242,971
Total plan assets at beginning of year	2009-12-31	$222,155
Value of fidelity bond covering the plan	2009-12-31	$30,000
Other income received	2009-12-31	$20,860
Net income (gross income less expenses)	2009-12-31	$20,816
Net plan assets at end of year (total assets less liabilities)	2009-12-31	$242,236
Net plan assets at beginning of year (total assets less liabilities)	2009-12-31	$221,420
Expenses. Administrative service providers (salaries,fees and commissions)	2009-12-31	$44
2008 : BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2008 401k financial data
Total plan liabilities at end of year	2008-12-31	$735
Total plan liabilities at beginning of year	2008-12-31	$0
Total income from all sources	2008-12-31	$-72,012
Expenses. Total of all expenses incurred	2008-12-31	$3,776
Benefits paid (including direct rollovers)	2008-12-31	$3,769
Total plan assets at end of year	2008-12-31	$222,155
Total plan assets at beginning of year	2008-12-31	$297,208
Value of fidelity bond covering the plan	2008-12-31	$30,000
Other income received	2008-12-31	$-72,012
Net income (gross income less expenses)	2008-12-31	$-75,788
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$221,420
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$297,208
Expenses. Administrative service providers (salaries,fees and commissions)	2008-12-31	$7

Form 5500 Responses for BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST

2011: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 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
2010: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 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: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 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
2008: BRUCE E. BOSSE, M.D., P.C. 401K PROFIT SHARING PLAN & TRUST 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Trust	Yes
2008-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	BRUCE E. BOSSE, M.D., P.C.
Employer identification number (EIN):	582082912
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)