401k Plan data: STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN plan

STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN 401k Plan overview

Plan Name	STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN
Plan identification number	002

STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN Benefits

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

401k Sponsoring company profile

STEVEN J DAVIS SR DO has sponsored the creation of one or more 401k plans.

Company Name: STEVEN J DAVIS SR DO

Employer identification number (EIN): 752259645

NAIC Classification: 621320
NAIC Description: Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2013-01-01 STEVEN J. DAVIS, SR
002 2012-01-01 STEVEN J. DAVIS, SR

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2013-01-01	STEVEN J. DAVIS, SR
002	2012-01-01	STEVEN J. DAVIS, SR

Plan Statistics for STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN

401k plan membership statisitcs for STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN

Measure Date Value
2013: STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 0
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 5
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 0
Total of all active and inactive participants 2012-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 5
Number of participants with account balances 2012-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2013: STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	0
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	5
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	0
Total of all active and inactive participants	2012-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	5
Number of participants with account balances	2012-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN

Measure	Date	Value
2013 : STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$69,364
Expenses. Total of all expenses incurred	2013-12-31	$992,486
Benefits paid (including direct rollovers)	2013-12-31	$992,286
Total plan assets at end of year	2013-12-31	$0
Total plan assets at beginning of year	2013-12-31	$923,122
Other income received	2013-12-31	$69,166
Net income (gross income less expenses)	2013-12-31	$-923,122
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$923,122
Total contributions received or receivable from employer(s)	2013-12-31	$198
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$200
2012 : STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$142,888
Expenses. Total of all expenses incurred	2012-12-31	$31,067
Benefits paid (including direct rollovers)	2012-12-31	$30,667
Total plan assets at end of year	2012-12-31	$923,122
Total plan assets at beginning of year	2012-12-31	$811,301
Other income received	2012-12-31	$73,354
Net income (gross income less expenses)	2012-12-31	$111,821
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$923,122
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$811,301
Total contributions received or receivable from employer(s)	2012-12-31	$69,534
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$400

Form 5500 Responses for STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN

2013: STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	This submission is the final filing	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: STEVEN J. DAVIS, SR, DO PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	STEVEN J DAVIS SR DO
Employer identification number (EIN):	752259645
NAIC Classification:	621320
NAIC Description:	Offices of Optometrists