401k Plan data: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST plan

FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST
Plan identification number	001

FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST Benefits

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

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

Company Name: FAROUK BARBANDI, M.D., P.A.

Employer identification number (EIN): 760042854

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-10-01 FAROUK BARBANDI, MD FAROUK BARBANDI, MD 2013-07-15
001 2010-10-01 FAROUK BARBANDI, M.D. FAROUK BARBANDI, M.D. 2012-07-12
001 2009-10-01 FAROUK BARBANDI, M.D. FAROUK BARBANDI, M.D. 2011-07-06

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2011-10-01	FAROUK BARBANDI, MD	FAROUK BARBANDI, MD	2013-07-15
001	2010-10-01	FAROUK BARBANDI, M.D.	FAROUK BARBANDI, M.D.	2012-07-12
001	2009-10-01	FAROUK BARBANDI, M.D.	FAROUK BARBANDI, M.D.	2011-07-06

Plan Statistics for FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST

Measure Date Value
2011: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-10-01 3
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 0
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 0
Total of all active and inactive participants 2011-10-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-10-01 0
Total participants 2011-10-01 0
Number of participants with account balances 2011-10-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-10-01 0
2010: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year 2010-10-01 3
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 2
Number of retired or separated participants receiving benefits 2010-10-01 0
Number of other retired or separated participants entitled to future benefits 2010-10-01 1
Total of all active and inactive participants 2010-10-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-10-01 0
Total participants 2010-10-01 3
Number of participants with account balances 2010-10-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-10-01 0
2009: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-10-01 3
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 3
Number of retired or separated participants receiving benefits 2009-10-01 0
Number of other retired or separated participants entitled to future benefits 2009-10-01 0
Total of all active and inactive participants 2009-10-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-10-01 0
Total participants 2009-10-01 3
Number of participants with account balances 2009-10-01 3

Measure	Date	Value
2011: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-10-01	3
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	0
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	0
Total of all active and inactive participants	2011-10-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-10-01	0
Total participants	2011-10-01	0
Number of participants with account balances	2011-10-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-10-01	0
2010: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year	2010-10-01	3
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	2
Number of retired or separated participants receiving benefits	2010-10-01	0
Number of other retired or separated participants entitled to future benefits	2010-10-01	1
Total of all active and inactive participants	2010-10-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-10-01	0
Total participants	2010-10-01	3
Number of participants with account balances	2010-10-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-10-01	0
2009: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-10-01	3
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	3
Number of retired or separated participants receiving benefits	2009-10-01	0
Number of other retired or separated participants entitled to future benefits	2009-10-01	0
Total of all active and inactive participants	2009-10-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-10-01	0
Total participants	2009-10-01	3
Number of participants with account balances	2009-10-01	3

Financial Data on FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2012 : FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2012 401k financial data
Total income from all sources	2012-09-30	$188,118
Expenses. Total of all expenses incurred	2012-09-30	$1,059,939
Benefits paid (including direct rollovers)	2012-09-30	$1,059,939
Total plan assets at end of year	2012-09-30	$0
Total plan assets at beginning of year	2012-09-30	$871,821
Other income received	2012-09-30	$188,118
Net income (gross income less expenses)	2012-09-30	$-871,821
Net plan assets at end of year (total assets less liabilities)	2012-09-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-09-30	$871,821
2011 : FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Total income from all sources	2011-09-30	$141,583
Total plan assets at end of year	2011-09-30	$871,821
Total plan assets at beginning of year	2011-09-30	$730,238
Other income received	2011-09-30	$141,583
Net income (gross income less expenses)	2011-09-30	$141,583
Net plan assets at end of year (total assets less liabilities)	2011-09-30	$871,821
Net plan assets at beginning of year (total assets less liabilities)	2011-09-30	$730,238

Form 5500 Responses for FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST

2011: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	This submission is the final filing	Yes
2011-10-01	Plan funding arrangement – Trust	Yes
2011-10-01	Plan benefit arrangement - Trust	Yes
2010: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2010 form 5500 responses
2010-10-01	Type of plan entity	Single employer plan
2010-10-01	Plan funding arrangement – Trust	Yes
2010-10-01	Plan benefit arrangement - Trust	Yes
2009: FAROUK BARBANDI MD PA PROFIT SHARING PLAN AND TRUST 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Plan funding arrangement – Trust	Yes
2009-10-01	Plan benefit arrangement - Trust	Yes

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Company Name:	FAROUK BARBANDI, M.D., P.A.
Employer identification number (EIN):	760042854
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)