401k Plan data: PROFIT SHARING PLAN FBO RICHARD M. BLANK plan

PROFIT SHARING PLAN FBO RICHARD M. BLANK 401k Plan overview

Plan Name	PROFIT SHARING PLAN FBO RICHARD M. BLANK
Plan identification number	003

PROFIT SHARING PLAN FBO RICHARD M. BLANK Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Money purchase (other than target benefit) 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. Participant-directed brokerage accounts provided as an investment option under the plan.

401k Sponsoring company profile

RICHARD M. BLANK, DDS has sponsored the creation of one or more 401k plans.

Company Name: RICHARD M. BLANK, DDS

Employer identification number (EIN): 112718614

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROFIT SHARING PLAN FBO RICHARD M. BLANK

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2015-01-01 RICHARD BLANK
003 2014-01-01 RICHARD BLANK
003 2014-01-01 RICHARD BLANK
003 2013-01-01 RICHARD BLANK
003 2012-01-01 RICHARD BLANK
003 2011-01-01 RICHARD BLANK
003 2009-01-01 RICHARD BLANK
003 2009-01-01 RICHARD BLANK

Plan id#	Filing Submission Date	Name of Administrator
003	2015-01-01	RICHARD BLANK
003	2014-01-01	RICHARD BLANK
003	2014-01-01	RICHARD BLANK
003	2013-01-01	RICHARD BLANK
003	2012-01-01	RICHARD BLANK
003	2011-01-01	RICHARD BLANK
003	2009-01-01	RICHARD BLANK
003	2009-01-01	RICHARD BLANK

Plan Statistics for PROFIT SHARING PLAN FBO RICHARD M. BLANK

401k plan membership statisitcs for PROFIT SHARING PLAN FBO RICHARD M. BLANK

Measure Date Value
2015: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2015 401k membership
Total participants, beginning-of-year 2015-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 2
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 2
Number of participants with account balances 2014-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 2
Number of participants with account balances 2013-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 2
Number of participants with account balances 2012-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 2
Number of participants with account balances 2011-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 2
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 2
Number of participants with account balances 2009-01-01 2

Measure	Date	Value
2015: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2015 401k membership
Total participants, beginning-of-year	2015-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	2
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	2
Number of participants with account balances	2014-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	2
Number of participants with account balances	2013-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	2
Number of participants with account balances	2012-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	2
Number of participants with account balances	2011-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	2
Number of participants with account balances	2009-01-01	2

Financial Data on PROFIT SHARING PLAN FBO RICHARD M. BLANK

Measure	Date	Value
2015 : PROFIT SHARING PLAN FBO RICHARD M. BLANK 2015 401k financial data
Total income from all sources	2015-12-31	$7,433
Expenses. Total of all expenses incurred	2015-12-31	$298,669
Benefits paid (including direct rollovers)	2015-12-31	$298,669
Total plan assets at end of year	2015-12-31	$0
Total plan assets at beginning of year	2015-12-31	$291,236
Other income received	2015-12-31	$7,433
Net income (gross income less expenses)	2015-12-31	$-291,236
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$291,236
2014 : PROFIT SHARING PLAN FBO RICHARD M. BLANK 2014 401k financial data
Total income from all sources	2014-12-31	$48,187
Expenses. Total of all expenses incurred	2014-12-31	$7,944
Benefits paid (including direct rollovers)	2014-12-31	$7,932
Total plan assets at end of year	2014-12-31	$291,236
Total plan assets at beginning of year	2014-12-31	$250,993
Expenses. Other expenses not covered elsewhere	2014-12-31	$12
Other income received	2014-12-31	$44,592
Net income (gross income less expenses)	2014-12-31	$40,243
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$291,236
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$250,993
Total contributions received or receivable from employer(s)	2014-12-31	$3,595
2013 : PROFIT SHARING PLAN FBO RICHARD M. BLANK 2013 401k financial data
Total income from all sources	2013-12-31	$82,372
Expenses. Total of all expenses incurred	2013-12-31	$5,539
Benefits paid (including direct rollovers)	2013-12-31	$5,527
Total plan assets at end of year	2013-12-31	$250,993
Total plan assets at beginning of year	2013-12-31	$174,160
Expenses. Other expenses not covered elsewhere	2013-12-31	$12
Other income received	2013-12-31	$78,777
Net income (gross income less expenses)	2013-12-31	$76,833
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$250,993
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$174,160
Total contributions received or receivable from employer(s)	2013-12-31	$3,595
2012 : PROFIT SHARING PLAN FBO RICHARD M. BLANK 2012 401k financial data
Total income from all sources	2012-12-31	$34,998
Expenses. Total of all expenses incurred	2012-12-31	$12
Total plan assets at end of year	2012-12-31	$174,160
Total plan assets at beginning of year	2012-12-31	$136,174
Expenses. Other expenses not covered elsewhere	2012-12-31	$12
Other income received	2012-12-31	$31,903
Net income (gross income less expenses)	2012-12-31	$34,986
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$174,160
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$136,174
Total contributions received or receivable from employer(s)	2012-12-31	$3,095
2011 : PROFIT SHARING PLAN FBO RICHARD M. BLANK 2011 401k financial data
Total income from all sources	2011-12-31	$-23,920
Expenses. Total of all expenses incurred	2011-12-31	$4,010
Benefits paid (including direct rollovers)	2011-12-31	$4,000
Total plan assets at end of year	2011-12-31	$136,174
Total plan assets at beginning of year	2011-12-31	$164,104
Expenses. Other expenses not covered elsewhere	2011-12-31	$10
Other income received	2011-12-31	$-27,015
Net income (gross income less expenses)	2011-12-31	$-27,930
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$136,174
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$164,104
Total contributions received or receivable from employer(s)	2011-12-31	$3,095
2010 : PROFIT SHARING PLAN FBO RICHARD M. BLANK 2010 401k financial data
Total income from all sources	2010-12-31	$16,804
Expenses. Total of all expenses incurred	2010-12-31	$17,010
Benefits paid (including direct rollovers)	2010-12-31	$17,000
Total plan assets at end of year	2010-12-31	$164,104
Total plan assets at beginning of year	2010-12-31	$164,310
Expenses. Other expenses not covered elsewhere	2010-12-31	$10
Other income received	2010-12-31	$11,979
Net income (gross income less expenses)	2010-12-31	$-206
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$164,104
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$164,310
Total contributions received or receivable from employer(s)	2010-12-31	$4,825

Form 5500 Responses for PROFIT SHARING PLAN FBO RICHARD M. BLANK

2015: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	This submission is the final filing	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PROFIT SHARING PLAN FBO RICHARD M. BLANK 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PROFIT SHARING PLAN FBO RICHARD M. BLANK 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: PROFIT SHARING PLAN FBO RICHARD M. BLANK 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:	RICHARD M. BLANK, DDS
Employer identification number (EIN):	112718614
NAIC Classification:	621210
NAIC Description:	Offices of Dentists