401k Plan data: PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN plan

PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN
Plan identification number	001

PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN 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.
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

DAVID R. DAYNES DDS, LLC has sponsored the creation of one or more 401k plans.

Company Name: DAVID R. DAYNES DDS, LLC

Employer identification number (EIN): 202806440

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 DAVID DAYNES DAVID DAYNES 2013-07-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2012-01-01	DAVID DAYNES		DAVID DAYNES	2013-07-11

Plan Statistics for PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN

Measure Date Value
2012: PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3
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 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 3
Number of participants with account balances 2012-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2012: PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3
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	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	3
Number of participants with account balances	2012-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2012 : PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
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	$45,210
Expenses. Total of all expenses incurred	2012-12-31	$0
Benefits paid (including direct rollovers)	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$45,210
Total plan assets at beginning of year	2012-12-31	$0
Total contributions received or receivable from participants	2012-12-31	$30,000
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	$0
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$45,210
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$45,210
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$0
Total contributions received or receivable from employer(s)	2012-12-31	$15,210
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

Form 5500 Responses for PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN

2012: PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
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

Potentially related plans

PLEASANT GROVE DENTAL 401(K) PROFIT SHARING PLAN [EIN = 461733553]

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Company Name:	DAVID R. DAYNES DDS, LLC
Employer identification number (EIN):	202806440
NAIC Classification:	621210
NAIC Description:	Offices of Dentists