401k Plan data: JACK B. SHUMATE, M.D., P.A. 401(K) PROFIT SHARING PLAN plan

JACK B. SHUMATE, M.D., P.A. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	JACK B. SHUMATE, M.D., P.A. 401(K) PROFIT SHARING PLAN
Plan identification number	001

JACK B. SHUMATE, M.D., P.A. 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
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
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.

401k Sponsoring company profile

JACK B. SHUMATE, M.D., P.A. has sponsored the creation of one or more 401k plans.

Company Name: JACK B. SHUMATE, M.D., P.A.

Employer identification number (EIN): 593562065

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JACK B. SHUMATE, M.D., P.A. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2010-01-01 JACK SHUMATE 2011-07-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2010-01-01	JACK SHUMATE	2011-07-25

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Company Name:	JACK B. SHUMATE, M.D., P.A.
Employer identification number (EIN):	593562065
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)