401k Plan data: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN plan

NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 401k Plan overview

Plan Name	NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN
Plan identification number	001

NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.

401k Sponsoring company profile

NORTHWEST INTERNAL MEDICINE SC has sponsored the creation of one or more 401k plans.

Company Name: NORTHWEST INTERNAL MEDICINE SC

Employer identification number (EIN): 362683847

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWEST INTERNAL MEDICINE SC 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 AJAY JAIN MD
001 2011-01-01 AJAY JAIN MD
001 2009-01-01 AJAY JAIN MD

Plan id#	Filing Submission Date	Name of Administrator
001	2012-01-01	AJAY JAIN MD
001	2011-01-01	AJAY JAIN MD
001	2009-01-01	AJAY JAIN MD

Plan Statistics for NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN

401k plan membership statisitcs for NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN

Measure Date Value
2012: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 3
Total of all active and inactive participants 2012-01-01 0
Total participants 2012-01-01 0
2011: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3
Total of all active and inactive participants 2011-01-01 3
Total participants 2011-01-01 3
Number of participants with account balances 2011-01-01 3
2009: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3
Total of all active and inactive participants 2009-01-01 3
Total participants 2009-01-01 3
Number of participants with account balances 2009-01-01 3

Measure	Date	Value
2012: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	3
Total of all active and inactive participants	2012-01-01	0
Total participants	2012-01-01	0
2011: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3
Total of all active and inactive participants	2011-01-01	3
Total participants	2011-01-01	3
Number of participants with account balances	2011-01-01	3
2009: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3
Total of all active and inactive participants	2009-01-01	3
Total participants	2009-01-01	3
Number of participants with account balances	2009-01-01	3

Financial Data on NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN

Measure	Date	Value
2012 : NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$-72,428
Expenses. Total of all expenses incurred	2012-12-31	$554,520
Benefits paid (including direct rollovers)	2012-12-31	$554,520
Total plan assets at end of year	2012-12-31	$0
Total plan assets at beginning of year	2012-12-31	$626,948
Other income received	2012-12-31	$-72,428
Net income (gross income less expenses)	2012-12-31	$-626,948
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$626,948
2011 : NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$80,920
Total plan assets at end of year	2011-12-31	$626,948
Total plan assets at beginning of year	2011-12-31	$546,028
Other income received	2011-12-31	$80,389
Net income (gross income less expenses)	2011-12-31	$80,920
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$626,948
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$546,028
Total contributions received or receivable from employer(s)	2011-12-31	$531
2010 : NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$61,449
Total plan assets at end of year	2010-12-31	$546,028
Total plan assets at beginning of year	2010-12-31	$484,579
Other income received	2010-12-31	$61,449
Net income (gross income less expenses)	2010-12-31	$61,449
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$546,028
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$484,579

Form 5500 Responses for NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN

2012: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: NORTHWEST INTERNAL MEDICINE SC PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	NORTHWEST INTERNAL MEDICINE SC
Employer identification number (EIN):	362683847
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)