401k Plan data: DEREK A. OSBORNE, DDS 401(K) PLAN plan

DEREK A. OSBORNE, DDS 401(K) PLAN 401k Plan overview

Plan Name	DEREK A. OSBORNE, DDS 401(K) PLAN
Plan identification number	101

DEREK A. OSBORNE, DDS 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
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

DEREK A. OSBORNE, DDS has sponsored the creation of one or more 401k plans.

Company Name: DEREK A. OSBORNE, DDS

Employer identification number (EIN): 412279565

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DEREK A. OSBORNE, DDS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
101 2023-01-01 DEREK OSBORNE 2024-10-01
101 2022-01-01 TARA EVANS, FOR TAG RESOURCES 2023-09-22
101 2021-01-01 TARA EVANS 2022-09-23
101 2021-01-01 TARA EVANS, FOR TAG RESOURCES 2023-09-14
101 2020-01-01 PHIL TISUE 2021-09-24
101 2019-01-01 PHIL TISUE 2020-10-15
101 2018-01-01 PHIL TISUE 2019-10-25
101 2018-01-01 PHIL TISUE 2020-12-15
101 2017-01-01 PHIL TISUE 2018-08-21
101 2016-01-01 PHIL TISUE 2017-08-28
101 2015-01-01 PHIL TISUE 2016-09-28
101 2014-01-01 PHIL TISUE 2015-07-08
101 2013-01-01 PHIL TISUE 2014-09-30
101 2012-01-01 PHIL TISUE 2013-09-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
101	2023-01-01	DEREK OSBORNE	2024-10-01
101	2022-01-01	TARA EVANS, FOR TAG RESOURCES	2023-09-22
101	2021-01-01	TARA EVANS	2022-09-23
101	2021-01-01	TARA EVANS, FOR TAG RESOURCES	2023-09-14
101	2020-01-01	PHIL TISUE	2021-09-24
101	2019-01-01	PHIL TISUE	2020-10-15
101	2018-01-01	PHIL TISUE	2019-10-25
101	2018-01-01	PHIL TISUE	2020-12-15
101	2017-01-01	PHIL TISUE	2018-08-21
101	2016-01-01	PHIL TISUE	2017-08-28
101	2015-01-01	PHIL TISUE	2016-09-28
101	2014-01-01	PHIL TISUE	2015-07-08
101	2013-01-01	PHIL TISUE	2014-09-30
101	2012-01-01	PHIL TISUE	2013-09-13

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Company Name:	DEREK A. OSBORNE, DDS
Employer identification number (EIN):	412279565
NAIC Classification:	621210
NAIC Description:	Offices of Dentists