401k Plan data: LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST plan

LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST
Plan identification number	002

LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing

401k Sponsoring company profile

BRETT J. KARLIK, MD, PC has sponsored the creation of one or more 401k plans.

Company Name: BRETT J. KARLIK, MD, PC

Employer identification number (EIN): 251437693

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-06-01 LUIS LU 2013-08-29 LUIS LU 2013-08-29
002 2011-06-01 LUIS LU 2013-03-14 LUIS LU 2013-03-14
002 2009-06-01 LUIS LU 2011-03-24
002 2009-06-01 LUIS LU 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2012-06-01	LUIS LU	2013-08-29	LUIS LU	2013-08-29
002	2011-06-01	LUIS LU	2013-03-14	LUIS LU	2013-03-14
002	2009-06-01			LUIS LU	2011-03-24
002	2009-06-01			LUIS LU	2010-10-14

Plan Statistics for LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST

Measure Date Value
2009: LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-06-01 16
Total number of active participants reported on line 7a of the Form 5500 2009-06-01 12
Number of retired or separated participants receiving benefits 2009-06-01 0
Number of other retired or separated participants entitled to future benefits 2009-06-01 4
Total of all active and inactive participants 2009-06-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-06-01 0
Total participants 2009-06-01 16

Measure	Date	Value
2009: LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-06-01	16
Total number of active participants reported on line 7a of the Form 5500	2009-06-01	12
Number of retired or separated participants receiving benefits	2009-06-01	0
Number of other retired or separated participants entitled to future benefits	2009-06-01	4
Total of all active and inactive participants	2009-06-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-06-01	0
Total participants	2009-06-01	16

Financial Data on LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2011 : LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Transfers to/from the plan	2011-05-31	$0
Total income from all sources	2011-05-31	$71,619
Expenses. Total of all expenses incurred	2011-05-31	$17,001
Benefits paid (including direct rollovers)	2011-05-31	$17,001
Total plan assets at end of year	2011-05-31	$749,816
Total plan assets at beginning of year	2011-05-31	$695,198
Total contributions received or receivable from participants	2011-05-31	$0
Expenses. Other expenses not covered elsewhere	2011-05-31	$0
Contributions received from other sources (not participants or employers)	2011-05-31	$0
Other income received	2011-05-31	$35,001
Noncash contributions received	2011-05-31	$0
Net income (gross income less expenses)	2011-05-31	$54,618
Net plan assets at end of year (total assets less liabilities)	2011-05-31	$749,816
Net plan assets at beginning of year (total assets less liabilities)	2011-05-31	$695,198
Total contributions received or receivable from employer(s)	2011-05-31	$36,618
Value of certain deemed distributions of participant loans	2011-05-31	$0
Value of corrective distributions	2011-05-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-05-31	$0

Form 5500 Responses for LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST

2009: LUIS W LU MD PC PROFIT SHARING PLAN AND TRUST 2009 form 5500 responses
2009-06-01	Type of plan entity	Single employer plan
2009-06-01	Submission has been amended	Yes
2009-06-01	This submission is the final filing	No
2009-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-06-01	Plan is a collectively bargained plan	No
2009-06-01	Plan funding arrangement – Trust	Yes
2009-06-01	Plan benefit arrangement - Trust	Yes

Potentially related plans

LUIS W KIM DDS MS INC. 401(K) P/S PLAN [EIN = 263159596]

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Company Name:	BRETT J. KARLIK, MD, PC
Employer identification number (EIN):	251437693
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)