401k Plan data: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN plan

J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN
Plan identification number	501

J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

J. PAONESSA, M.D., P.A. has sponsored the creation of one or more 401k plans.

Company Name: J. PAONESSA, M.D., P.A.

Employer identification number (EIN): 593379136

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

Additional information about J. PAONESSA, M.D., P.A.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1996-05-28

Company Identification Number: P96000044895

Legal Registered Office Address: 1201 5TH AVE NORTH

ST PETERSBURG

33705

More information about J. PAONESSA, M.D., P.A.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2009-06-01 JEFFREY PAONESSA
501 2007-06-01 DR. JEFFREY L. PAONESSA 2010-03-01 DR. JEFFREY L. PAONESSA 2010-04-02
501 2006-06-01 DR. JEFFREY L. PAONESSA 2010-03-01 DR. JEFFREY L. PAONESSA 2010-04-02
501 2005-06-01 DR. JEFFREY L. PAONESSA 2010-03-01 DR. JEFFREY L. PAONESSA 2010-04-02

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2009-06-01	JEFFREY PAONESSA
501	2007-06-01	DR. JEFFREY L. PAONESSA	2010-03-01	DR. JEFFREY L. PAONESSA	2010-04-02
501	2006-06-01	DR. JEFFREY L. PAONESSA	2010-03-01	DR. JEFFREY L. PAONESSA	2010-04-02
501	2005-06-01	DR. JEFFREY L. PAONESSA	2010-03-01	DR. JEFFREY L. PAONESSA	2010-04-02

Plan Statistics for J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN

Measure Date Value
2009: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-06-01 344
Total number of active participants reported on line 7a of the Form 5500 2009-06-01 280
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 0
Total of all active and inactive participants 2009-06-01 280
2007: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year 2007-06-01 238
Total number of active participants reported on line 7a of the Form 5500 2007-06-01 367
Number of retired or separated participants receiving benefits 2007-06-01 0
Number of other retired or separated participants entitled to future benefits 2007-06-01 0
Total of all active and inactive participants 2007-06-01 367
2006: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year 2006-06-01 202
Total number of active participants reported on line 7a of the Form 5500 2006-06-01 238
Number of retired or separated participants receiving benefits 2006-06-01 0
Number of other retired or separated participants entitled to future benefits 2006-06-01 0
Total of all active and inactive participants 2006-06-01 238
2005: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year 2005-06-01 0
Total number of active participants reported on line 7a of the Form 5500 2005-06-01 202
Number of retired or separated participants receiving benefits 2005-06-01 0
Number of other retired or separated participants entitled to future benefits 2005-06-01 0
Total of all active and inactive participants 2005-06-01 202

Measure	Date	Value
2009: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-06-01	344
Total number of active participants reported on line 7a of the Form 5500	2009-06-01	280
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	0
Total of all active and inactive participants	2009-06-01	280
2007: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year	2007-06-01	238
Total number of active participants reported on line 7a of the Form 5500	2007-06-01	367
Number of retired or separated participants receiving benefits	2007-06-01	0
Number of other retired or separated participants entitled to future benefits	2007-06-01	0
Total of all active and inactive participants	2007-06-01	367
2006: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year	2006-06-01	202
Total number of active participants reported on line 7a of the Form 5500	2006-06-01	238
Number of retired or separated participants receiving benefits	2006-06-01	0
Number of other retired or separated participants entitled to future benefits	2006-06-01	0
Total of all active and inactive participants	2006-06-01	238
2005: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year	2005-06-01	0
Total number of active participants reported on line 7a of the Form 5500	2005-06-01	202
Number of retired or separated participants receiving benefits	2005-06-01	0
Number of other retired or separated participants entitled to future benefits	2005-06-01	0
Total of all active and inactive participants	2005-06-01	202

Form 5500 Responses for J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN

2009: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-06-01	Type of plan entity	Single employer plan
2009-06-01	This submission is the final filing	No
2009-06-01	Plan funding arrangement – Insurance	Yes
2009-06-01	Plan benefit arrangement – Insurance	Yes
2007: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2007 form 5500 responses
2007-06-01	Type of plan entity	Single employer plan
2007-06-01	This submission is the final filing	No
2007-06-01	Plan funding arrangement – Insurance	Yes
2007-06-01	Plan benefit arrangement – Insurance	Yes
2006: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2006 form 5500 responses
2006-06-01	Type of plan entity	Single employer plan
2006-06-01	This submission is the final filing	No
2006-06-01	Plan funding arrangement – Insurance	Yes
2006-06-01	Plan benefit arrangement – Insurance	Yes
2005: J. PAONESSA, M.D., P.A. EMPLOYEE BENEFIT PLAN 2005 form 5500 responses
2005-06-01	Type of plan entity	Single employer plan
2005-06-01	First time form 5500 has been submitted	Yes
2005-06-01	This submission is the final filing	No
2005-06-01	Plan funding arrangement – Insurance	Yes
2005-06-01	Plan benefit arrangement – Insurance	Yes

Potentially related plans

J. PAONESSA, M.D., P.A. 401(K) PROFIT SHARING PLAN [EIN = 593379138]

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Company Name:	J. PAONESSA, M.D., P.A.
Employer identification number (EIN):	593379136
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1996-05-28
Company Identification Number:	P96000044895
Legal Registered Office Address:	1201 5TH AVE NORTH ST PETERSBURG 33705