401k Plan data: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN plan

DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 401k Plan overview

Plan Name	DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN
Plan identification number	002

DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing Plan covering Self-Employed individuals. 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

DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR has sponsored the creation of one or more 401k plans.

Company Name: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR

Employer identification number (EIN): 680164711

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-01-01 DAVID PFEIFER 2016-01-15
002 2014-01-01 DAVID PFEIFER 2015-05-22
002 2013-01-01 DAVID PFEIFER 2014-09-18
002 2012-01-01 DAVID PFEIFER
002 2011-01-01 DAVID PFEIFER
002 2009-01-01 DAVID PFEIFER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2015-01-01	DAVID PFEIFER	2016-01-15
002	2014-01-01	DAVID PFEIFER	2015-05-22
002	2013-01-01	DAVID PFEIFER	2014-09-18
002	2012-01-01	DAVID PFEIFER
002	2011-01-01	DAVID PFEIFER
002	2009-01-01	DAVID PFEIFER

Plan Statistics for DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN

401k plan membership statisitcs for DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN

Measure Date Value
2012: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 4
Number of participants with account balances 2012-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 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 2
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 2
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
2009: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3
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 1
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

Measure	Date	Value
2012: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	4
Number of participants with account balances	2012-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 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	2
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	2
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
2009: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3
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	1
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

Financial Data on DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN

Measure	Date	Value
2012 : DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$63,382
Expenses. Total of all expenses incurred	2012-12-31	$30,068
Benefits paid (including direct rollovers)	2012-12-31	$30,068
Total plan assets at end of year	2012-12-31	$869,404
Total plan assets at beginning of year	2012-12-31	$836,090
Value of fidelity bond covering the plan	2012-12-31	$200,000
Total contributions received or receivable from participants	2012-12-31	$0
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$43,382
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$33,314
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$869,404
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$836,090
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$175,000
Total contributions received or receivable from employer(s)	2012-12-31	$20,000
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$0
2011 : DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$28,222
Expenses. Total of all expenses incurred	2011-12-31	$28,671
Benefits paid (including direct rollovers)	2011-12-31	$28,671
Total plan assets at end of year	2011-12-31	$836,090
Total plan assets at beginning of year	2011-12-31	$836,539
Value of fidelity bond covering the plan	2011-12-31	$200,000
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$8,222
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-449
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$836,090
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$836,539
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$175,000
Total contributions received or receivable from employer(s)	2011-12-31	$20,000
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$0
2010 : DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$103,206
Expenses. Total of all expenses incurred	2010-12-31	$0
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$836,539
Total plan assets at beginning of year	2010-12-31	$733,333
Value of fidelity bond covering the plan	2010-12-31	$200,000
Total contributions received or receivable from participants	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$0
Noncash contributions received	2010-12-31	$83,206
Net income (gross income less expenses)	2010-12-31	$103,206
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$836,539
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$733,333
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$175,000
Total contributions received or receivable from employer(s)	2010-12-31	$20,000
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0

Form 5500 Responses for DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN

2012: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR 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	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
2009: DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR 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:	DAVID L. PFEIFER, D.D.S., SOLE PROPRIETOR
Employer identification number (EIN):	680164711
NAIC Classification:	621210
NAIC Description:	Offices of Dentists