401k Plan data: HEATHER A. WOLOSHYN, D.M.D., M.S.D. , PLLC 401(K) PROFIT SHARING PLAN AND TRUST plan

HEATHER A. WOLOSHYN, D.M.D., M.S.D. , PLLC 401(K) PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	HEATHER A. WOLOSHYN, D.M.D., M.S.D. , PLLC 401(K) PROFIT SHARING PLAN AND TRUST
Plan identification number	001

HEATHER A. WOLOSHYN, D.M.D., M.S.D. , PLLC 401(K) PROFIT SHARING PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

HEATHER A. WOLOSHYN, D.M.D., M.S.D. , PLLC has sponsored the creation of one or more 401k plans.

Company Name: HEATHER A. WOLOSHYN, D.M.D., M.S.D. , PLLC

Employer identification number (EIN): 912087056

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEATHER A. WOLOSHYN, D.M.D., M.S.D. , PLLC 401(K) PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 HEATHER A. WOLOSHYN 2016-09-27 HEATHER A. WOLOSHYN 2016-09-27
001 2016-01-01 HEATHER A. WOLOSHYN 2016-09-27 HEATHER A. WOLOSHYN 2016-09-27
001 2015-01-01 HEATHER A. WOLOSHYN 2016-09-27 HEATHER A. WOLOSHYN 2016-09-27
001 2014-01-01 HEATHER A. WOLOSHYN 2015-09-30 HEATHER A. WOLOSHYN 2015-09-30
001 2013-01-01 HEATHER A. WOLOSHYN 2014-10-13 HEATHER A. WOLOSHYN 2014-10-13
001 2012-01-01 HEATHER A. WOLOSHYN 2013-10-15 HEATHER A. WOLOSHYN 2013-10-15
001 2011-01-01 HEATHER A. WOLOSHYN 2012-12-16 HEATHER A. WOLOSHYN 2012-12-16
001 2010-01-01 HEATHER A. WOLOSHYN 2011-10-13 HEATHER A. WOLOSHYN 2011-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	HEATHER A. WOLOSHYN	2016-09-27	HEATHER A. WOLOSHYN	2016-09-27
001	2016-01-01	HEATHER A. WOLOSHYN	2016-09-27	HEATHER A. WOLOSHYN	2016-09-27
001	2015-01-01	HEATHER A. WOLOSHYN	2016-09-27	HEATHER A. WOLOSHYN	2016-09-27
001	2014-01-01	HEATHER A. WOLOSHYN	2015-09-30	HEATHER A. WOLOSHYN	2015-09-30
001	2013-01-01	HEATHER A. WOLOSHYN	2014-10-13	HEATHER A. WOLOSHYN	2014-10-13
001	2012-01-01	HEATHER A. WOLOSHYN	2013-10-15	HEATHER A. WOLOSHYN	2013-10-15
001	2011-01-01	HEATHER A. WOLOSHYN	2012-12-16	HEATHER A. WOLOSHYN	2012-12-16
001	2010-01-01	HEATHER A. WOLOSHYN	2011-10-13	HEATHER A. WOLOSHYN	2011-10-13

Potentially related plans

HEATHER A. TAYLOR, PLLC 401(K) PROFIT SHARING PLAN [EIN = 270220903]

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Company Name:	HEATHER A. WOLOSHYN, D.M.D., M.S.D. , PLLC
Employer identification number (EIN):	912087056
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)