401k Plan data: EDMUND TKACZUK, M.D. plan

EDMUND TKACZUK, M.D. 401k Plan overview

Plan Name	EDMUND TKACZUK, M.D.
Plan identification number	002

EDMUND TKACZUK, M.D. Benefits

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

EDMUND TKACZUK, M.D. has sponsored the creation of one or more 401k plans.

Company Name: EDMUND TKACZUK, M.D.

Employer identification number (EIN): 521562080

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EDMUND TKACZUK, M.D.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2014-01-01 DENNIS DRISCOLL DENNIS DRISCOLL 2015-10-14
002 2013-01-01 DENNIS DRISCOLL DENNIS DRISCOLL 2014-09-30
002 2012-01-01 DENNIS DRISCOLL
002 2011-01-01 DENNIS DRISCOLL
002 2010-01-01 DENNIS DRISCOLL
002 2009-01-01 DENNIS DRISCOLL

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2014-01-01	DENNIS DRISCOLL	DENNIS DRISCOLL	2015-10-14
002	2013-01-01	DENNIS DRISCOLL	DENNIS DRISCOLL	2014-09-30
002	2012-01-01	DENNIS DRISCOLL
002	2011-01-01	DENNIS DRISCOLL
002	2010-01-01	DENNIS DRISCOLL
002	2009-01-01	DENNIS DRISCOLL

Plan Statistics for EDMUND TKACZUK, M.D.

401k plan membership statisitcs for EDMUND TKACZUK, M.D.

Measure Date Value
2014: EDMUND TKACZUK, M.D. 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
2013: EDMUND TKACZUK, M.D. 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1
Total of all active and inactive participants 2013-01-01 1
Total participants 2013-01-01 1
Number of participants with account balances 2013-01-01 1
2012: EDMUND TKACZUK, M.D. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1
Total of all active and inactive participants 2012-01-01 1
Total participants 2012-01-01 1
Number of participants with account balances 2012-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: EDMUND TKACZUK, M.D. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 4
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
2010: EDMUND TKACZUK, M.D. 2010 401k membership
Total participants, beginning-of-year 2010-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 4
Total of all active and inactive participants 2010-01-01 4
Total participants 2010-01-01 4
Number of participants with account balances 2010-01-01 4
2009: EDMUND TKACZUK, M.D. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
Total of all active and inactive participants 2009-01-01 4
Total participants 2009-01-01 4
Number of participants with account balances 2009-01-01 4

Measure	Date	Value
2014: EDMUND TKACZUK, M.D. 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
2013: EDMUND TKACZUK, M.D. 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1
Total of all active and inactive participants	2013-01-01	1
Total participants	2013-01-01	1
Number of participants with account balances	2013-01-01	1
2012: EDMUND TKACZUK, M.D. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1
Total of all active and inactive participants	2012-01-01	1
Total participants	2012-01-01	1
Number of participants with account balances	2012-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: EDMUND TKACZUK, M.D. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	4
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
2010: EDMUND TKACZUK, M.D. 2010 401k membership
Total participants, beginning-of-year	2010-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	4
Total of all active and inactive participants	2010-01-01	4
Total participants	2010-01-01	4
Number of participants with account balances	2010-01-01	4
2009: EDMUND TKACZUK, M.D. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
Total of all active and inactive participants	2009-01-01	4
Total participants	2009-01-01	4
Number of participants with account balances	2009-01-01	4

Financial Data on EDMUND TKACZUK, M.D.

Measure	Date	Value
2014 : EDMUND TKACZUK, M.D. 2014 401k financial data
Total income from all sources	2014-12-31	$0
Expenses. Total of all expenses incurred	2014-12-31	$271,091
Benefits paid (including direct rollovers)	2014-12-31	$271,091
Total plan assets at end of year	2014-12-31	$0
Total plan assets at beginning of year	2014-12-31	$271,091
Value of fidelity bond covering the plan	2014-12-31	$120,000
Net income (gross income less expenses)	2014-12-31	$-271,091
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$271,091
2013 : EDMUND TKACZUK, M.D. 2013 401k financial data
Total income from all sources	2013-12-31	$0
Expenses. Total of all expenses incurred	2013-12-31	$104,645
Benefits paid (including direct rollovers)	2013-12-31	$104,645
Total plan assets at end of year	2013-12-31	$271,091
Total plan assets at beginning of year	2013-12-31	$375,736
Value of fidelity bond covering the plan	2013-12-31	$120,000
Net income (gross income less expenses)	2013-12-31	$-104,645
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$271,091
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$375,736
2012 : EDMUND TKACZUK, M.D. 2012 401k financial data
Total income from all sources	2012-12-31	$23,974
Expenses. Total of all expenses incurred	2012-12-31	$49,225
Benefits paid (including direct rollovers)	2012-12-31	$49,225
Total plan assets at end of year	2012-12-31	$375,736
Total plan assets at beginning of year	2012-12-31	$400,987
Value of fidelity bond covering the plan	2012-12-31	$120,000
Other income received	2012-12-31	$23,974
Net income (gross income less expenses)	2012-12-31	$-25,251
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$375,736
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$400,987
2011 : EDMUND TKACZUK, M.D. 2011 401k financial data
Total income from all sources	2011-12-31	$30,139
Expenses. Total of all expenses incurred	2011-12-31	$999,297
Benefits paid (including direct rollovers)	2011-12-31	$999,297
Total plan assets at end of year	2011-12-31	$400,987
Total plan assets at beginning of year	2011-12-31	$1,370,145
Value of fidelity bond covering the plan	2011-12-31	$120,000
Net income (gross income less expenses)	2011-12-31	$-969,158
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$400,987
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,370,145
Total contributions received or receivable from employer(s)	2011-12-31	$30,139
2010 : EDMUND TKACZUK, M.D. 2010 401k financial data
Total income from all sources	2010-12-31	$343,945
Total plan assets at end of year	2010-12-31	$1,370,145
Total plan assets at beginning of year	2010-12-31	$1,026,200
Value of fidelity bond covering the plan	2010-12-31	$120,000
Other income received	2010-12-31	$321,821
Net income (gross income less expenses)	2010-12-31	$343,945
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,370,145
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,026,200
Total contributions received or receivable from employer(s)	2010-12-31	$22,124

Form 5500 Responses for EDMUND TKACZUK, M.D.

2014: EDMUND TKACZUK, M.D. 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: EDMUND TKACZUK, M.D. 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: EDMUND TKACZUK, M.D. 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: EDMUND TKACZUK, M.D. 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: EDMUND TKACZUK, M.D. 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: EDMUND TKACZUK, M.D. 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:	EDMUND TKACZUK, M.D.
Employer identification number (EIN):	521562080
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)