401k Plan data: KIDS FIRST PEDIATRICS, P.C. 401K PLAN plan

KIDS FIRST PEDIATRICS, P.C. 401K PLAN 401k Plan overview

Plan Name	KIDS FIRST PEDIATRICS, P.C. 401K PLAN
Plan identification number	001

KIDS FIRST PEDIATRICS, P.C. 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.

401k Sponsoring company profile

KIDS FIRST PEDIATRICS, P.C. has sponsored the creation of one or more 401k plans.

Company Name: KIDS FIRST PEDIATRICS, P.C.

Employer identification number (EIN): 113217113

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

Additional information about KIDS FIRST PEDIATRICS, P.C.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1994-09-13

Company Identification Number: 1851273

Legal Registered Office Address: 815 HALLOCK AVE
SUFFOLK
PORT JEFFERSON STAT
United States of America (USA)
11776

More information about KIDS FIRST PEDIATRICS, P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KIDS FIRST PEDIATRICS, P.C. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 DAMIAN FORLETTI
001 2014-01-01 DAMIAN FORLETTI
001 2013-01-01 DAMIAN FORLETTI DAMIAN FORLETTI 2014-03-21
001 2012-01-01 DAMIAN FORLETTI
001 2011-01-01 DAMIAN FORLETTI
001 2010-01-01 DAMIAN FORLETTI
001 2009-01-01 DAMIAN FORLETTI

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2015-01-01	DAMIAN FORLETTI
001	2014-01-01	DAMIAN FORLETTI
001	2013-01-01	DAMIAN FORLETTI	DAMIAN FORLETTI	2014-03-21
001	2012-01-01	DAMIAN FORLETTI
001	2011-01-01	DAMIAN FORLETTI
001	2010-01-01	DAMIAN FORLETTI
001	2009-01-01	DAMIAN FORLETTI

Plan Statistics for KIDS FIRST PEDIATRICS, P.C. 401K PLAN

401k plan membership statisitcs for KIDS FIRST PEDIATRICS, P.C. 401K PLAN

Measure Date Value
2015: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 19
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 6
Total of all active and inactive participants 2014-01-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 25
Number of participants with account balances 2014-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 19
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 16
Total of all active and inactive participants 2013-01-01 35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 35
Number of participants with account balances 2013-01-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 38
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 30
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 5
Total of all active and inactive participants 2012-01-01 35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 35
Number of participants with account balances 2012-01-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 33
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 31
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 7
Total of all active and inactive participants 2011-01-01 38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 38
Number of participants with account balances 2011-01-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 30
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 3
Total of all active and inactive participants 2010-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 33
Number of participants with account balances 2010-01-01 33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 30
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 22
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 1
Total of all active and inactive participants 2009-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 23
Number of participants with account balances 2009-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	19
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	6
Total of all active and inactive participants	2014-01-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	25
Number of participants with account balances	2014-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	19
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	16
Total of all active and inactive participants	2013-01-01	35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	35
Number of participants with account balances	2013-01-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	38
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	30
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	5
Total of all active and inactive participants	2012-01-01	35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	35
Number of participants with account balances	2012-01-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	33
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	31
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	7
Total of all active and inactive participants	2011-01-01	38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	38
Number of participants with account balances	2011-01-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	30
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	3
Total of all active and inactive participants	2010-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	33
Number of participants with account balances	2010-01-01	33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	30
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	22
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	1
Total of all active and inactive participants	2009-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	23
Number of participants with account balances	2009-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on KIDS FIRST PEDIATRICS, P.C. 401K PLAN

Measure	Date	Value
2015 : KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$12,132
Expenses. Total of all expenses incurred	2015-12-31	$2,384,661
Benefits paid (including direct rollovers)	2015-12-31	$2,384,661
Total plan assets at end of year	2015-12-31	$0
Total plan assets at beginning of year	2015-12-31	$2,372,529
Value of fidelity bond covering the plan	2015-12-31	$250,000
Total contributions received or receivable from participants	2015-12-31	$0
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$12,132
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-2,372,529
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$2,372,529
Total contributions received or receivable from employer(s)	2015-12-31	$0
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$0
2014 : KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$267,291
Expenses. Total of all expenses incurred	2014-12-31	$304,729
Benefits paid (including direct rollovers)	2014-12-31	$304,729
Total plan assets at end of year	2014-12-31	$2,372,529
Total plan assets at beginning of year	2014-12-31	$2,409,967
Value of fidelity bond covering the plan	2014-12-31	$250,000
Total contributions received or receivable from participants	2014-12-31	$93,875
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$133,993
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$-37,438
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,372,529
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,409,967
Total contributions received or receivable from employer(s)	2014-12-31	$39,423
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
2013 : KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$482,360
Expenses. Total of all expenses incurred	2013-12-31	$18,757
Benefits paid (including direct rollovers)	2013-12-31	$18,757
Total plan assets at end of year	2013-12-31	$2,409,967
Total plan assets at beginning of year	2013-12-31	$1,946,364
Value of fidelity bond covering the plan	2013-12-31	$250,000
Total contributions received or receivable from participants	2013-12-31	$99,956
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$334,947
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$463,603
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,409,967
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,946,364
Total contributions received or receivable from employer(s)	2013-12-31	$47,457
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$0
2012 : KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$350,339
Expenses. Total of all expenses incurred	2012-12-31	$18,610
Benefits paid (including direct rollovers)	2012-12-31	$18,610
Total plan assets at end of year	2012-12-31	$1,946,364
Total plan assets at beginning of year	2012-12-31	$1,614,635
Value of fidelity bond covering the plan	2012-12-31	$250,000
Total contributions received or receivable from participants	2012-12-31	$101,189
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$198,640
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$331,729
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,946,364
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,614,635
Total contributions received or receivable from employer(s)	2012-12-31	$50,510
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$0
2011 : KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$178,448
Expenses. Total of all expenses incurred	2011-12-31	$16,061
Benefits paid (including direct rollovers)	2011-12-31	$16,061
Total plan assets at end of year	2011-12-31	$1,614,635
Total plan assets at beginning of year	2011-12-31	$1,452,248
Total contributions received or receivable from participants	2011-12-31	$92,928
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-42,663
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$162,387
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,614,635
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,452,248
Total contributions received or receivable from employer(s)	2011-12-31	$128,183
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
2010 : KIDS FIRST PEDIATRICS, P.C. 401K 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	$388,664
Expenses. Total of all expenses incurred	2010-12-31	$97,219
Benefits paid (including direct rollovers)	2010-12-31	$97,219
Total plan assets at end of year	2010-12-31	$1,452,248
Total plan assets at beginning of year	2010-12-31	$1,160,803
Total contributions received or receivable from participants	2010-12-31	$95,707
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$850
Other income received	2010-12-31	$160,293
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$291,445
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,452,248
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,160,803
Total contributions received or receivable from employer(s)	2010-12-31	$131,814
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

Form 5500 Responses for KIDS FIRST PEDIATRICS, P.C. 401K PLAN

2015: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: KIDS FIRST PEDIATRICS, P.C. 401K 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	No
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: KIDS FIRST PEDIATRICS, P.C. 401K 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: KIDS FIRST PEDIATRICS, P.C. 401K 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: KIDS FIRST PEDIATRICS, P.C. 401K PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
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:	KIDS FIRST PEDIATRICS, P.C.
Employer identification number (EIN):	113217113
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1994-09-13
Company Identification Number:	1851273
Legal Registered Office Address:	815 HALLOCK AVE SUFFOLK PORT JEFFERSON STAT United States of America (USA) 11776