401k Plan data: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN plan

RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 401k Plan overview

Plan Name	RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN
Plan identification number	001

RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) 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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

RAFAEL RIVERA, JR., D.D.S., PLLC has sponsored the creation of one or more 401k plans.

Company Name: RAFAEL RIVERA, JR., D.D.S., PLLC

Employer identification number (EIN): 261995249

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2012-01-01 REAGAN LENHART
001 2011-01-01 REAGAN K. LENHART
001 2010-01-01 REAGAN LENHART
001 2009-01-01 REAGAN K. LENHART REAGAN K. LENHART 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2012-01-01	REAGAN LENHART
001	2011-01-01	REAGAN K. LENHART
001	2010-01-01	REAGAN LENHART
001	2009-01-01	REAGAN K. LENHART	REAGAN K. LENHART	2010-10-13

Plan Statistics for RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN

401k plan membership statisitcs for RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN

Measure Date Value
2022: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 198
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 24
Total of all active and inactive participants 2022-01-01 222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 222
Number of participants with account balances 2022-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 197
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 133
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 10
Total of all active and inactive participants 2021-01-01 143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 143
Number of participants with account balances 2021-01-01 129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2012: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 311
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 234
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 232
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 79
Total of all active and inactive participants 2011-01-01 311
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 311
Number of participants with account balances 2011-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 249
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 215
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 19
Total of all active and inactive participants 2010-01-01 234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 234
Number of participants with account balances 2010-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 241
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 212
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 37
Total of all active and inactive participants 2009-01-01 249
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 249
Number of participants with account balances 2009-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	198
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	24
Total of all active and inactive participants	2022-01-01	222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	222
Number of participants with account balances	2022-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	197
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	133
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	10
Total of all active and inactive participants	2021-01-01	143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	143
Number of participants with account balances	2021-01-01	129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2012: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	311
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	234
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	232
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	79
Total of all active and inactive participants	2011-01-01	311
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	311
Number of participants with account balances	2011-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	249
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	215
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	19
Total of all active and inactive participants	2010-01-01	234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	234
Number of participants with account balances	2010-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	241
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	212
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	37
Total of all active and inactive participants	2009-01-01	249
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	249
Number of participants with account balances	2009-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN

Measure	Date	Value
2022 : RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$904,134
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$27,231
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$20,558
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,072,225
Value of total assets at end of year	2022-12-31	$1,723,233
Value of total assets at beginning of year	2022-12-31	$846,330
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$6,673
Total interest from all sources	2022-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$11,921
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$11,921
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$250,000
If this is an individual account plan, was there a blackout period	2022-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$682,239
Participant contributions at end of year	2022-12-31	$18,748
Participant contributions at beginning of year	2022-12-31	$18,414
Total non interest bearing cash at end of year	2022-12-31	$296
Total non interest bearing cash at beginning of year	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$876,903
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$1,723,233
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$846,330
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$6,673
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$1,625,594
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$785,411
Interest on participant loans	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$68,315
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$31,147
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$31,147
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-180,012
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$389,986
Employer contributions (assets) at end of year	2022-12-31	$10,280
Employer contributions (assets) at beginning of year	2022-12-31	$11,358
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$20,558
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2022-12-31	Yes
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	PARSONS CPA, PLLC
Accountancy firm EIN	2022-12-31	274214364
2021 : RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$850,490
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$4,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$3,428
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$826,936
Value of total assets at end of year	2021-12-31	$846,330
Value of total assets at beginning of year	2021-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$732
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$8,628
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$8,628
Administrative expenses professional fees incurred	2021-12-31	$732
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$250,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$562,413
Participant contributions at end of year	2021-12-31	$18,414
Participant contributions at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$846,330
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$846,330
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$785,411
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$31,147
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$14,926
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$264,523
Employer contributions (assets) at end of year	2021-12-31	$11,358
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$3,428
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	PARSONS CPA, PLLC
Accountancy firm EIN	2021-12-31	274214364
2012 : RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$73,978
Total of all expenses incurred	2012-12-31	$1,309,355
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,264,584
Value of total corrective distributions	2012-12-31	$44,452
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$0
Value of total assets at end of year	2012-12-31	$0
Value of total assets at beginning of year	2012-12-31	$1,235,377
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$319
Total interest from all sources	2012-12-31	$263
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$150,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$0
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$7,377
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-1,235,377
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,235,377
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$319
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,207,420
Interest on participant loans	2012-12-31	$76
Interest earned on other investments	2012-12-31	$187
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$20,580
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$73,715
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,264,584
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	MCPHERSON BREYFOGLE DAVELINE GOODRI
Accountancy firm EIN	2012-12-31	840628988
2011 : RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$233,379
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$361,977
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$287,782
Expenses. Certain deemed distributions of participant loans	2011-12-31	$0
Value of total corrective distributions	2011-12-31	$71,480
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$288,430
Value of total assets at end of year	2011-12-31	$1,235,377
Value of total assets at beginning of year	2011-12-31	$1,363,975
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$2,715
Total interest from all sources	2011-12-31	$812
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$150,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$288,430
Participant contributions at end of year	2011-12-31	$7,377
Participant contributions at beginning of year	2011-12-31	$5,838
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$11,346
Other income not declared elsewhere	2011-12-31	$12
Administrative expenses (other) incurred	2011-12-31	$2,715
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-128,598
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,235,377
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,363,975
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$1,207,420
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,330,059
Interest on participant loans	2011-12-31	$261
Interest earned on other investments	2011-12-31	$551
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$20,580
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$16,732
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-55,875
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$287,782
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MCPHERSON,BREYFOGLE,DARELINE,GOODRI
Accountancy firm EIN	2011-12-31	840628988
2010 : RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$426,785
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$156,567
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$91,004
Expenses. Certain deemed distributions of participant loans	2010-12-31	$0
Value of total corrective distributions	2010-12-31	$62,833
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$269,010
Value of total assets at end of year	2010-12-31	$1,363,975
Value of total assets at beginning of year	2010-12-31	$1,093,757
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$2,730
Total interest from all sources	2010-12-31	$622
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$150,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$268,793
Participant contributions at end of year	2010-12-31	$5,838
Participant contributions at beginning of year	2010-12-31	$0
Participant contributions at end of year	2010-12-31	$11,346
Participant contributions at beginning of year	2010-12-31	$8,139
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$217
Other income not declared elsewhere	2010-12-31	$1
Administrative expenses (other) incurred	2010-12-31	$2,730
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$270,218
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,363,975
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,093,757
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$1,330,059
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$1,068,682
Interest on participant loans	2010-12-31	$101
Interest earned on other investments	2010-12-31	$521
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$16,732
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$16,936
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$157,152
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$91,004
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	MCPHERSON,BREYFOGLE,DARELINE,GOODRI
Accountancy firm EIN	2010-12-31	840628988
2009 : RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) 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 RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN

2022: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) 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: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	First time form 5500 has been submitted	Yes
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
2012: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	This submission is the final filing	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) 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 – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: RAFAEL RIVERA, JR., D.D.S., PLLC 401(K) 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 – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	RAFAEL RIVERA, JR., D.D.S., PLLC
Employer identification number (EIN):	261995249
NAIC Classification:	621210
NAIC Description:	Offices of Dentists