401k Plan data: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN plan

DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 401k Plan overview

Plan Name	DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN
Plan identification number	001

DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME 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

DRS. CHARLES L. & MARIA V. PUCEVICH has sponsored the creation of one or more 401k plans.

Company Name: DRS. CHARLES L. & MARIA V. PUCEVICH

Employer identification number (EIN): 251422899

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 CHARLES PUCEVICH M.D. 2015-05-27
001 2013-01-01 CHARLES PUCEVICH M.D.
001 2012-01-01 CHARLES PUCEVICH M.D.
001 2011-01-01 CHARLES PUCEVICH M.D.
001 2010-01-01 CHARLES PUCEVICH M.D.
001 2009-01-01 CHARLES PUCEVICH M.D.

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2014-01-01	CHARLES PUCEVICH M.D.	2015-05-27
001	2013-01-01	CHARLES PUCEVICH M.D.
001	2012-01-01	CHARLES PUCEVICH M.D.
001	2011-01-01	CHARLES PUCEVICH M.D.
001	2010-01-01	CHARLES PUCEVICH M.D.
001	2009-01-01	CHARLES PUCEVICH M.D.

Plan Statistics for DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN

401k plan membership statisitcs for DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN

Measure Date Value
2013: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 11
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 2
Total of all active and inactive participants 2013-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 13
Number of participants with account balances 2013-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 13
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 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 13
Number of participants with account balances 2012-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 14
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 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 14
Number of participants with account balances 2011-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 11
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 2
Total of all active and inactive participants 2010-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 13
Number of participants with account balances 2010-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 13
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 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 13
Number of participants with account balances 2009-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2013: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	11
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	2
Total of all active and inactive participants	2013-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	13
Number of participants with account balances	2013-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	13
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	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	13
Number of participants with account balances	2012-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	14
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	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	14
Number of participants with account balances	2011-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	11
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	2
Total of all active and inactive participants	2010-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	13
Number of participants with account balances	2010-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	13
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	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	13
Number of participants with account balances	2009-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN

Measure	Date	Value
2013 : DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2013 401k financial data
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	$283,698
Expenses. Total of all expenses incurred	2013-12-31	$1,741
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$3,430,795
Total plan assets at beginning of year	2013-12-31	$3,148,838
Value of fidelity bond covering the plan	2013-12-31	$150,000
Total contributions received or receivable from participants	2013-12-31	$0
Expenses. Other expenses not covered elsewhere	2013-12-31	$1,741
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$159,958
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$281,957
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$3,430,795
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,148,838
Total contributions received or receivable from employer(s)	2013-12-31	$123,740
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME 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	$259,585
Expenses. Total of all expenses incurred	2012-12-31	$21,541
Benefits paid (including direct rollovers)	2012-12-31	$21,541
Total plan assets at end of year	2012-12-31	$3,148,838
Total plan assets at beginning of year	2012-12-31	$2,910,794
Value of fidelity bond covering the plan	2012-12-31	$150,000
Total contributions received or receivable from participants	2012-12-31	$0
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	$139,602
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$238,044
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,148,838
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,910,794
Total contributions received or receivable from employer(s)	2012-12-31	$119,983
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 : DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME 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	$67,829
Expenses. Total of all expenses incurred	2011-12-31	$42,729
Benefits paid (including direct rollovers)	2011-12-31	$20,988
Total plan assets at end of year	2011-12-31	$2,910,794
Total plan assets at beginning of year	2011-12-31	$2,885,694
Value of fidelity bond covering the plan	2011-12-31	$150,000
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$1,741
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-47,476
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$25,100
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,910,794
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,885,694
Total contributions received or receivable from employer(s)	2011-12-31	$115,305
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	$20,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME 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	$249,133
Expenses. Total of all expenses incurred	2010-12-31	$21,041
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$2,885,694
Total plan assets at beginning of year	2010-12-31	$2,657,602
Value of fidelity bond covering the plan	2010-12-31	$150,000
Total contributions received or receivable from participants	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$1,741
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$132,226
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$228,092
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,885,694
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,657,602
Total contributions received or receivable from employer(s)	2010-12-31	$116,907
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	$19,300
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME PLAN

2013: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME 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: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME 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: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME 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: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME 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: DRS. CHARLES & MARIA PUCEVICH RETIREMENT INCOME 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:	DRS. CHARLES L. & MARIA V. PUCEVICH
Employer identification number (EIN):	251422899
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)