401k Plan data: TANTRA DJAYA, D.D.S., INC. 401K PLAN plan

TANTRA DJAYA, D.D.S., INC. 401K PLAN 401k Plan overview

Plan Name	TANTRA DJAYA, D.D.S., INC. 401K PLAN
Plan identification number	002

TANTRA DJAYA, D.D.S., INC. 401K 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
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.
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

TANTRA DJAYA, D.D.S., INC. has sponsored the creation of one or more 401k plans.

Company Name: TANTRA DJAYA, D.D.S., INC.

Employer identification number (EIN): 200540288

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TANTRA DJAYA, D.D.S., INC. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 TANTRA DJAYA, D.D.S. 2023-10-03 TANTRA DJAYA, D.D.S. 2023-10-03
002 2021-01-01 TANTRA DJAYA, D.D.S. 2022-08-12 TANTRA DJAYA, D.D.S. 2022-08-12
002 2020-01-01 TANTRA DJAYA, D.D.S. 2021-10-06 TANTRA DJAYA, D.D.S. 2021-10-06
002 2019-01-01 TANTRA DJAYA, D.D.S. 2020-10-02 TANTRA DJAYA, D.D.S. 2020-10-02

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01	TANTRA DJAYA, D.D.S.	2023-10-03	TANTRA DJAYA, D.D.S.	2023-10-03
002	2021-01-01	TANTRA DJAYA, D.D.S.	2022-08-12	TANTRA DJAYA, D.D.S.	2022-08-12
002	2020-01-01	TANTRA DJAYA, D.D.S.	2021-10-06	TANTRA DJAYA, D.D.S.	2021-10-06
002	2019-01-01	TANTRA DJAYA, D.D.S.	2020-10-02	TANTRA DJAYA, D.D.S.	2020-10-02

Plan Statistics for TANTRA DJAYA, D.D.S., INC. 401K PLAN

401k plan membership statisitcs for TANTRA DJAYA, D.D.S., INC. 401K PLAN

Measure Date Value
2022: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 7
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 1
Total of all active and inactive participants 2022-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 8
Number of participants with account balances 2022-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 1
2021: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 8
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 8
Number of participants with account balances 2021-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 7
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 7
Number of participants with account balances 2020-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 6
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 6
Number of participants with account balances 2019-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0

Measure	Date	Value
2022: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	7
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	1
Total of all active and inactive participants	2022-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	8
Number of participants with account balances	2022-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	1
2021: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	8
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	8
Number of participants with account balances	2021-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	7
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	7
Number of participants with account balances	2020-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	6
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	6
Number of participants with account balances	2019-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0

Financial Data on TANTRA DJAYA, D.D.S., INC. 401K PLAN

Measure	Date	Value
2022 : TANTRA DJAYA, D.D.S., INC. 401K PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$0
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$771,363
Expenses. Total of all expenses incurred	2022-12-31	$11,257
Benefits paid (including direct rollovers)	2022-12-31	$6,864
Total plan assets at end of year	2022-12-31	$3,775,855
Total plan assets at beginning of year	2022-12-31	$3,015,749
Value of fidelity bond covering the plan	2022-12-31	$300,000
Total contributions received or receivable from participants	2022-12-31	$82,300
Expenses. Other expenses not covered elsewhere	2022-12-31	$0
Contributions received from other sources (not participants or employers)	2022-12-31	$0
Other income received	2022-12-31	$568,584
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$760,106
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$3,775,855
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$3,015,749
Assets. Value of participant loans	2022-12-31	$1,404
Assets. Value of real-estate (other than employer real property)	2022-12-31	$3,100,000
Total contributions received or receivable from employer(s)	2022-12-31	$120,479
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$4,393
2021 : TANTRA DJAYA, D.D.S., INC. 401K PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$577,238
Expenses. Total of all expenses incurred	2021-12-31	$1,805
Benefits paid (including direct rollovers)	2021-12-31	$0
Total plan assets at end of year	2021-12-31	$3,015,749
Total plan assets at beginning of year	2021-12-31	$2,440,316
Value of fidelity bond covering the plan	2021-12-31	$300,000
Total contributions received or receivable from participants	2021-12-31	$78,950
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$395,238
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$575,433
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$3,015,749
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$2,440,316
Assets. Value of participant loans	2021-12-31	$2,682
Assets. Value of real-estate (other than employer real property)	2021-12-31	$0
Total contributions received or receivable from employer(s)	2021-12-31	$103,050
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$1,805
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : TANTRA DJAYA, D.D.S., INC. 401K PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$703,699
Expenses. Total of all expenses incurred	2020-12-31	$10,623
Benefits paid (including direct rollovers)	2020-12-31	$0
Total plan assets at end of year	2020-12-31	$2,440,316
Total plan assets at beginning of year	2020-12-31	$1,747,240
Value of fidelity bond covering the plan	2020-12-31	$300,000
Total contributions received or receivable from participants	2020-12-31	$50,750
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$506,419
Other income received	2020-12-31	$58,244
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$693,076
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$2,440,316
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$1,747,240
Assets. Value of participant loans	2020-12-31	$3,949
Assets. Value of real-estate (other than employer real property)	2020-12-31	$1,725,000
Total contributions received or receivable from employer(s)	2020-12-31	$88,286
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$10,623
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : TANTRA DJAYA, D.D.S., INC. 401K PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$1,725,000
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$22,240
Expenses. Total of all expenses incurred	2019-12-31	$0
Benefits paid (including direct rollovers)	2019-12-31	$0
Total plan assets at end of year	2019-12-31	$1,747,240
Total plan assets at beginning of year	2019-12-31	$0
Value of fidelity bond covering the plan	2019-12-31	$300,000
Total contributions received or receivable from participants	2019-12-31	$0
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$0
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$22,240
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$1,747,240
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$0
Assets. Value of real-estate (other than employer real property)	2019-12-31	$1,725,000
Total contributions received or receivable from employer(s)	2019-12-31	$22,240
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0

Form 5500 Responses for TANTRA DJAYA, D.D.S., INC. 401K PLAN

2022: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: TANTRA DJAYA, D.D.S., INC. 401K PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	First time form 5500 has been submitted	Yes
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	TANTRA DJAYA, D.D.S., INC.
Employer identification number (EIN):	200540288
NAIC Classification:	621210
NAIC Description:	Offices of Dentists