401k Plan data: PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN plan

PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN 401k Plan overview

Plan Name	PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN
Plan identification number	002

PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily flat dollar (includes dollars per year of service)
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Floor-offset plan - Plan benefits are subject to offset for retirement benefits provided by an employer-sponsored defined contribution plan.
Plan covering Self-Employed individuals.

401k Sponsoring company profile

PAUL J. VANDERHEYDEN, D.D.S. has sponsored the creation of one or more 401k plans.

Company Name: PAUL J. VANDERHEYDEN, D.D.S.

Employer identification number (EIN): 770300223

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 PAUL J. VANDERHEYDEN, D.D.S.
002 2011-01-01 PAUL J. VANDERHEYDEN, D.D.S.
002 2009-01-01 DOUGLAS S. HENDRY
002 2009-01-01 DOUGLAS S. HENDRY
002 2009-01-01 DOUGLAS S. HENDRY
002 2009-01-01 DOUGLAS S. HENDRY
002 2009-01-01 DOUGLAS S. HENDRY
002 2009-01-01 DOUGLAS S. HENDRY
002 2008-01-01

Plan Statistics for PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN

401k plan membership statisitcs for PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN

Measure Date Value
2012: PAUL J. VANDERHEYDEN, D.D.S. PENSION 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 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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 8
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 0
Total of all active and inactive participants 2011-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 8
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 0
Total of all active and inactive participants 2009-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 8
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: PAUL J. VANDERHEYDEN, D.D.S. PENSION 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 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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	8
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	0
Total of all active and inactive participants	2011-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	8
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	0
Total of all active and inactive participants	2009-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN

Measure	Date	Value
2012 : PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN 2012 401k financial data
Transfers to/from the plan	2012-09-30	$0
Total plan liabilities at end of year	2012-09-30	$0
Total plan liabilities at beginning of year	2012-09-30	$45
Total income from all sources	2012-09-30	$51,202
Expenses. Total of all expenses incurred	2012-09-30	$471,131
Benefits paid (including direct rollovers)	2012-09-30	$468,873
Total plan assets at end of year	2012-09-30	$0
Total plan assets at beginning of year	2012-09-30	$419,974
Value of fidelity bond covering the plan	2012-09-30	$100,000
Total contributions received or receivable from participants	2012-09-30	$0
Expenses. Other expenses not covered elsewhere	2012-09-30	$2,258
Contributions received from other sources (not participants or employers)	2012-09-30	$0
Other income received	2012-09-30	$51,202
Noncash contributions received	2012-09-30	$0
Net income (gross income less expenses)	2012-09-30	$-419,929
Net plan assets at end of year (total assets less liabilities)	2012-09-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-09-30	$419,929
Total contributions received or receivable from employer(s)	2012-09-30	$0
Value of certain deemed distributions of participant loans	2012-09-30	$0
Value of corrective distributions	2012-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-09-30	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-09-30	$468,873
2011 : PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$45
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$24,616
Expenses. Total of all expenses incurred	2011-12-31	$17,774
Benefits paid (including direct rollovers)	2011-12-31	$14,673
Total plan assets at end of year	2011-12-31	$419,974
Total plan assets at beginning of year	2011-12-31	$413,087
Value of fidelity bond covering the plan	2011-12-31	$100,000
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$3,101
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-11,921
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$6,842
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$419,929
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$413,087
Total contributions received or receivable from employer(s)	2011-12-31	$36,537
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : PAUL J. VANDERHEYDEN, D.D.S. PENSION 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	$152,245
Expenses. Total of all expenses incurred	2010-12-31	$2,303
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$413,087
Total plan assets at beginning of year	2010-12-31	$263,145
Value of fidelity bond covering the plan	2010-12-31	$100,000
Total contributions received or receivable from participants	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$2,303
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$40,021
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$149,942
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$413,087
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$263,145
Total contributions received or receivable from employer(s)	2010-12-31	$112,224
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : PAUL J. VANDERHEYDEN, D.D.S. PENSION 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	$0

Form 5500 Responses for PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN

2012: PAUL J. VANDERHEYDEN, D.D.S. PENSION 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	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: PAUL J. VANDERHEYDEN, D.D.S. PENSION 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: PAUL J. VANDERHEYDEN, D.D.S. PENSION PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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
2008: PAUL J. VANDERHEYDEN, D.D.S. PENSION 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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Company Name:	PAUL J. VANDERHEYDEN, D.D.S.
Employer identification number (EIN):	770300223
NAIC Classification:	621210
NAIC Description:	Offices of Dentists