401k Plan data: GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN plan

GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 401k Plan overview

Plan Name	GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN
Plan identification number	003

GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
Plan covering Self-Employed individuals.

401k Sponsoring company profile

GARY A. MOELLER, D.D.S. has sponsored the creation of one or more 401k plans.

Company Name: GARY A. MOELLER, D.D.S.

Employer identification number (EIN): 920066459

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2012-01-01 GARY A. MOELLER
003 2011-01-01 GARY A. MOELLER
003 2010-01-01 GARY A. MOELLER
003 2009-01-01 GARY A. MOELLER
003 2009-01-01 GARY A. MOELLER

Plan id#	Filing Submission Date	Name of Administrator
003	2012-01-01	GARY A. MOELLER
003	2011-01-01	GARY A. MOELLER
003	2010-01-01	GARY A. MOELLER
003	2009-01-01	GARY A. MOELLER
003	2009-01-01	GARY A. MOELLER

Plan Statistics for GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN

401k plan membership statisitcs for GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN

Measure Date Value
2012: GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 9
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
Number of participants with account balances 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: GARY A. MOELLER, D.D.S. PROFIT SHARING 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 9
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 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 9
Number of participants with account balances 2011-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 8
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 8
Number of participants with account balances 2010-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 1
2009: GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6
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 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 6
Number of participants with account balances 2009-01-01 6
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: GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	9
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
Number of participants with account balances	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: GARY A. MOELLER, D.D.S. PROFIT SHARING 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	9
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	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	9
Number of participants with account balances	2011-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	8
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	8
Number of participants with account balances	2010-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	1
2009: GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6
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	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	6
Number of participants with account balances	2009-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN

Measure	Date	Value
2012 : GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$8,984
Expenses. Total of all expenses incurred	2012-12-31	$770,424
Benefits paid (including direct rollovers)	2012-12-31	$766,097
Total plan assets at end of year	2012-12-31	$0
Total plan assets at beginning of year	2012-12-31	$761,440
Value of fidelity bond covering the plan	2012-12-31	$75,000
Other income received	2012-12-31	$8,984
Net income (gross income less expenses)	2012-12-31	$-761,440
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$761,440
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$4,327
2011 : GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$31,784
Expenses. Total of all expenses incurred	2011-12-31	$8,449
Total plan assets at end of year	2011-12-31	$761,440
Total plan assets at beginning of year	2011-12-31	$738,105
Value of fidelity bond covering the plan	2011-12-31	$75,000
Other income received	2011-12-31	$-28,216
Net income (gross income less expenses)	2011-12-31	$23,335
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$761,440
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$738,105
Total contributions received or receivable from employer(s)	2011-12-31	$60,000
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$8,449
2010 : GARY A. MOELLER, D.D.S. 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	$120,525
Expenses. Total of all expenses incurred	2010-12-31	$7,004
Total plan assets at end of year	2010-12-31	$738,105
Total plan assets at beginning of year	2010-12-31	$624,584
Value of fidelity bond covering the plan	2010-12-31	$75,000
Other income received	2010-12-31	$49,602
Net income (gross income less expenses)	2010-12-31	$113,521
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$738,105
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$624,584
Total contributions received or receivable from employer(s)	2010-12-31	$70,923
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$7,004

Form 5500 Responses for GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN

2012: GARY A. MOELLER, D.D.S. PROFIT SHARING 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)	No
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: GARY A. MOELLER, D.D.S. PROFIT SHARING 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
2010: GARY A. MOELLER, D.D.S. PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: GARY A. MOELLER, D.D.S. PROFIT SHARING 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

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Company Name:	GARY A. MOELLER, D.D.S.
Employer identification number (EIN):	920066459
NAIC Classification:	621210
NAIC Description:	Offices of Dentists