401k Plan data: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN plan

RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 401k Plan overview

Plan Name	RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN
Plan identification number	001

RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Money purchase (other than target benefit) 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

DR RICHARD CAPPS, DMD has sponsored the creation of one or more 401k plans.

Company Name: DR RICHARD CAPPS, DMD

Employer identification number (EIN): 610702770

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 RICHARD E. CAPPS, DMD
001 2011-01-01 RICHARD E. CAPPS, DMD
001 2009-01-01 RICHARD E. CAPPS, DMD

Plan id#	Filing Submission Date	Name of Administrator
001	2012-01-01	RICHARD E. CAPPS, DMD
001	2011-01-01	RICHARD E. CAPPS, DMD
001	2009-01-01	RICHARD E. CAPPS, DMD

Plan Statistics for RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN

401k plan membership statisitcs for RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN

Measure Date Value
2012: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
2011: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 2
Total participants 2011-01-01 2
Number of participants with account balances 2011-01-01 2
2009: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 1
Total of all active and inactive participants 2009-01-01 2
Total participants 2009-01-01 2
Number of participants with account balances 2009-01-01 2

Measure	Date	Value
2012: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
2011: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	2
Total participants	2011-01-01	2
Number of participants with account balances	2011-01-01	2
2009: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	1
Total of all active and inactive participants	2009-01-01	2
Total participants	2009-01-01	2
Number of participants with account balances	2009-01-01	2

Financial Data on RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN

Measure	Date	Value
2012 : RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$-184,436
Total income from all sources	2012-12-31	$10,277
Total plan assets at end of year	2012-12-31	$0
Total plan assets at beginning of year	2012-12-31	$174,159
Other income received	2012-12-31	$10,277
Net income (gross income less expenses)	2012-12-31	$10,277
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$174,159
2011 : RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$5,953
Total plan assets at end of year	2011-12-31	$174,159
Total plan assets at beginning of year	2011-12-31	$168,206
Other income received	2011-12-31	$5,953
Net income (gross income less expenses)	2011-12-31	$5,953
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$174,159
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$168,206
2010 : RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$27,435
Total plan assets at end of year	2010-12-31	$168,206
Total plan assets at beginning of year	2010-12-31	$140,771
Other income received	2010-12-31	$27,435
Net income (gross income less expenses)	2010-12-31	$27,435
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$168,206
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$140,771

Form 5500 Responses for RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN

2012: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	This submission is the final filing	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT 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
2009: RICHARD E CAPPS DMD SELF-EMPLOYED RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	DR RICHARD CAPPS, DMD
Employer identification number (EIN):	610702770
NAIC Classification:	621210
NAIC Description:	Offices of Dentists