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| Plan Name | KENNETH L. PETTIT, D.O., L.L.C. DEFINED BENEFIT PLAN |
| Plan identification number | 002 |
| 401k Plan Type | Defined Benefit Pension |
| Plan Features/Benefits |
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| Company Name: | KENNETH L PETTIT, DO LLC |
| Employer identification number (EIN): | 860956852 |
| NAIC Classification: | 621498 |
| NAIC Description: | All Other Outpatient Care Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 002 | 2009-01-01 | VANESSA PETTIT |
| Measure | Date | Value |
|---|---|---|
| 2009: KENNETH L. PETTIT, D.O., L.L.C. DEFINED BENEFIT 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 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 3 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2010 : KENNETH L. PETTIT, D.O., L.L.C. DEFINED BENEFIT PLAN 2010 401k financial data | ||
| Total income from all sources | 2010-12-31 | $3,287 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $203,910 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $198,788 |
| Total plan assets at end of year | 2010-12-31 | $0 |
| Total plan assets at beginning of year | 2010-12-31 | $200,623 |
| Value of fidelity bond covering the plan | 2010-12-31 | $35,000 |
| Other income received | 2010-12-31 | $-2,128 |
| Net income (gross income less expenses) | 2010-12-31 | $-200,623 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $200,623 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $5,415 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $5,122 |
| 2009: KENNETH L. PETTIT, D.O., L.L.C. DEFINED BENEFIT PLAN 2009 form 5500 responses | ||
|---|---|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
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