401k Plan data: DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN plan

DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN 401k Plan overview

Plan Name	DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN
Plan identification number	004

DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Floor-offset plan - Plan benefits are subject to offset for retirement benefits provided by an employer-sponsored defined contribution plan.
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

DENISE DIBONA, DDS has sponsored the creation of one or more 401k plans.

Company Name: DENISE DIBONA, DDS

Employer identification number (EIN): 222849606

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2012-01-01 DENISE DIBONA DENISE DIBONA 2013-06-24
004 2011-01-01 DENISE DIBONA DENISE DIBONA 2012-09-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
004	2012-01-01	DENISE DIBONA		DENISE DIBONA	2013-06-24
004	2011-01-01	DENISE DIBONA		DENISE DIBONA	2012-09-26

Plan Statistics for DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN

401k plan membership statisitcs for DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN

Measure Date Value
2012: DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 11
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 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 10
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 3
Total of all active and inactive participants 2011-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1

Measure	Date	Value
2012: DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	11
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	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	10
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	3
Total of all active and inactive participants	2011-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1

Financial Data on DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN

Measure	Date	Value
2012 : DENISE DIBONA, DDS DEFINED BENEFIT PENSION 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	$161,909
Expenses. Total of all expenses incurred	2012-12-31	$4,281
Benefits paid (including direct rollovers)	2012-12-31	$3,288
Total plan assets at end of year	2012-12-31	$701,335
Total plan assets at beginning of year	2012-12-31	$543,707
Value of fidelity bond covering the plan	2012-12-31	$100,000
Total contributions received or receivable from participants	2012-12-31	$0
Expenses. Other expenses not covered elsewhere	2012-12-31	$993
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$36,624
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$157,628
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$701,335
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$543,707
Total contributions received or receivable from employer(s)	2012-12-31	$125,285
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$83,787
Expenses. Total of all expenses incurred	2011-12-31	$914
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$543,707
Total plan assets at beginning of year	2011-12-31	$460,834
Value of fidelity bond covering the plan	2011-12-31	$100,000
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$914
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-25,629
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$82,873
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$543,707
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$460,834
Total contributions received or receivable from employer(s)	2011-12-31	$109,416
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0

Form 5500 Responses for DENISE DIBONA, DDS DEFINED BENEFIT PENSION PLAN

2012: DENISE DIBONA, DDS DEFINED BENEFIT PENSION 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: DENISE DIBONA, DDS DEFINED BENEFIT PENSION 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

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Company Name:	DENISE DIBONA, DDS
Employer identification number (EIN):	222849606
NAIC Classification:	621210
NAIC Description:	Offices of Dentists