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| Plan Name | JAMES W. CARLSON M.D., INC. EMPLOYEES PROFIT SHARING PLAN |
| Plan identification number | 002 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | JAMES W. CARLSON M.D., INC. |
| Employer identification number (EIN): | 731061005 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 002 | 2010-01-01 | JAMES W. CARLSON | JAMES W. CARLSON | 2011-03-11 | |
| 002 | 2009-01-01 | JAMES W. CARLSON | JAMES W. CARLSON | 2010-07-28 | |
| 002 | 2008-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2010: JAMES W. CARLSON M.D., INC. EMPLOYEES PROFIT SHARING PLAN 2010 401k membership | ||
| Total participants, beginning-of-year | 2010-01-01 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 0 |
| Number of participants with account balances | 2010-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: JAMES W. CARLSON M.D., INC. EMPLOYEES PROFIT SHARING PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1 |
| Total of all active and inactive participants | 2009-01-01 | 1 |
| Total participants | 2009-01-01 | 1 |
| Number of participants with account balances | 2009-01-01 | 1 |
| Measure | Date | Value |
|---|---|---|
| 2010 : JAMES W. CARLSON M.D., INC. EMPLOYEES PROFIT SHARING PLAN 2010 401k financial data | ||
| Total plan liabilities at beginning of year | 2010-12-31 | $0 |
| Total income from all sources | 2010-12-31 | $96,492 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $2,760,492 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $2,760,428 |
| Total plan assets at end of year | 2010-12-31 | $0 |
| Total plan assets at beginning of year | 2010-12-31 | $2,664,000 |
| Other income received | 2010-12-31 | $96,492 |
| Net income (gross income less expenses) | 2010-12-31 | $-2,664,000 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $2,664,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $64 |
| 2009 : JAMES W. CARLSON M.D., INC. EMPLOYEES PROFIT SHARING PLAN 2009 401k financial data | ||
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $20,000 |
| 2010: JAMES W. CARLSON M.D., INC. EMPLOYEES PROFIT SHARING PLAN 2010 form 5500 responses | ||
|---|---|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | This submission is the final filing | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: JAMES W. CARLSON M.D., INC. EMPLOYEES PROFIT SHARING PLAN 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| 2008: JAMES W. CARLSON M.D., INC. EMPLOYEES PROFIT SHARING PLAN 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 |
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