401k Plan data: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN plan

AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 401k Plan overview

Plan Name	AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN
Plan identification number	001

AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing

401k Sponsoring company profile

AMIR H. FATEMI, M.D.I.P.L has sponsored the creation of one or more 401k plans.

Company Name: AMIR H. FATEMI, M.D.I.P.L

Employer identification number (EIN): 592191237

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-05-01 AMIR H FATEMI MD
001 2011-05-01 AMIR H FATEMI MD
001 2010-05-01 AMIR H FATEMI MD

Plan id#	Filing Submission Date	Name of Administrator
001	2012-05-01	AMIR H FATEMI MD
001	2011-05-01	AMIR H FATEMI MD
001	2010-05-01	AMIR H FATEMI MD

Plan Statistics for AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN

401k plan membership statisitcs for AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN

Measure Date Value
2012: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-05-01 1
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 0
Total of all active and inactive participants 2012-05-01 0
Total participants 2012-05-01 0
Number of participants with account balances 2012-05-01 0
2011: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-05-01 1
Total number of active participants reported on line 7a of the Form 5500 2011-05-01 1
Total of all active and inactive participants 2011-05-01 1
Total participants 2011-05-01 1
Number of participants with account balances 2011-05-01 1
2010: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-05-01 1
Total number of active participants reported on line 7a of the Form 5500 2010-05-01 1
Total of all active and inactive participants 2010-05-01 1
Total participants 2010-05-01 1
Number of participants with account balances 2010-05-01 1

Measure	Date	Value
2012: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-05-01	1
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	0
Total of all active and inactive participants	2012-05-01	0
Total participants	2012-05-01	0
Number of participants with account balances	2012-05-01	0
2011: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-05-01	1
Total number of active participants reported on line 7a of the Form 5500	2011-05-01	1
Total of all active and inactive participants	2011-05-01	1
Total participants	2011-05-01	1
Number of participants with account balances	2011-05-01	1
2010: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-05-01	1
Total number of active participants reported on line 7a of the Form 5500	2010-05-01	1
Total of all active and inactive participants	2010-05-01	1
Total participants	2010-05-01	1
Number of participants with account balances	2010-05-01	1

Financial Data on AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN

Measure	Date	Value
2013 : AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-04-30	$0
Expenses. Total of all expenses incurred	2013-04-30	$62,750
Benefits paid (including direct rollovers)	2013-04-30	$62,750
Total plan assets at beginning of year	2013-04-30	$62,750
Other income received	2013-04-30	$0
Net income (gross income less expenses)	2013-04-30	$-62,750
Net plan assets at beginning of year (total assets less liabilities)	2013-04-30	$62,750
2012 : AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-04-30	$-208,250
Total plan assets at end of year	2012-04-30	$62,750
Total plan assets at beginning of year	2012-04-30	$271,000
Other income received	2012-04-30	$-208,250
Net income (gross income less expenses)	2012-04-30	$-208,250
Net plan assets at end of year (total assets less liabilities)	2012-04-30	$62,750
Net plan assets at beginning of year (total assets less liabilities)	2012-04-30	$271,000
2011 : AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-04-30	$-20,500
Total plan assets at end of year	2011-04-30	$271,000
Total plan assets at beginning of year	2011-04-30	$291,500
Other income received	2011-04-30	$-20,500
Net income (gross income less expenses)	2011-04-30	$-20,500
Net plan assets at end of year (total assets less liabilities)	2011-04-30	$271,000
Net plan assets at beginning of year (total assets less liabilities)	2011-04-30	$291,500

Form 5500 Responses for AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN

2012: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2012 form 5500 responses
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	This submission is the final filing	Yes
2012-05-01	Plan funding arrangement – Trust	Yes
2012-05-01	Plan benefit arrangement - Trust	Yes
2011: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2011 form 5500 responses
2011-05-01	Type of plan entity	Single employer plan
2011-05-01	Plan funding arrangement – Trust	Yes
2011-05-01	Plan benefit arrangement - Trust	Yes
2010: AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN 2010 form 5500 responses
2010-05-01	Type of plan entity	Single employer plan
2010-05-01	Plan funding arrangement – Trust	Yes
2010-05-01	Plan benefit arrangement - Trust	Yes

Potentially related plans

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Company Name:	AMIR H. FATEMI, M.D.I.P.L
Employer identification number (EIN):	592191237
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)