401k Plan data: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN plan

NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 401k Plan overview

Plan Name	NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN
Plan identification number	001

NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
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

NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. has sponsored the creation of one or more 401k plans.

Company Name: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C.

Employer identification number (EIN): 202908439

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 E. CODY GUNN, M.D. E. CODY GUNN, M.D. 2012-06-19
001 2011-01-01 E. CODY GUNN, MD E. CODY GUNN, MD 2012-06-19
001 2010-01-01 E. CODY GUNN, MD E. CODY GUNN, MD 2011-09-08

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2012-01-01	E. CODY GUNN, M.D.	E. CODY GUNN, M.D.	2012-06-19
001	2011-01-01	E. CODY GUNN, MD	E. CODY GUNN, MD	2012-06-19
001	2010-01-01	E. CODY GUNN, MD	E. CODY GUNN, MD	2011-09-08

Plan Statistics for NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN

401k plan membership statisitcs for NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN

Measure Date Value
2012: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3
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 2
Total of all active and inactive participants 2011-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 5
Number of participants with account balances 2011-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 3
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 2
Total of all active and inactive participants 2010-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 5
Number of participants with account balances 2010-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 1

Measure	Date	Value
2012: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3
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	2
Total of all active and inactive participants	2011-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	5
Number of participants with account balances	2011-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	3
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	2
Total of all active and inactive participants	2010-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	5
Number of participants with account balances	2010-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	1

Financial Data on NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN

Measure	Date	Value
2012 : NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-02-03	$0
Total plan liabilities at beginning of year	2012-02-03	$0
Expenses. Total of all expenses incurred	2012-02-03	$39,481
Benefits paid (including direct rollovers)	2012-02-03	$39,481
Total plan assets at end of year	2012-02-03	$0
Total plan assets at beginning of year	2012-02-03	$39,481
Net income (gross income less expenses)	2012-02-03	$-39,481
Net plan assets at end of year (total assets less liabilities)	2012-02-03	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-02-03	$39,481
2011 : NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$-3,110
Expenses. Total of all expenses incurred	2011-12-31	$493
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$39,481
Total plan assets at beginning of year	2011-12-31	$43,084
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-3,110
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-3,603
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$39,481
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$43,084
Total contributions received or receivable from employer(s)	2011-12-31	$0
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$493
2010 : NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$6,151
Expenses. Total of all expenses incurred	2010-12-31	$373
Total plan assets at end of year	2010-12-31	$43,084
Total plan assets at beginning of year	2010-12-31	$37,306
Other income received	2010-12-31	$6,151
Net income (gross income less expenses)	2010-12-31	$5,778
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$43,084
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$37,306
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$373

Form 5500 Responses for NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN

2012: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 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	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 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: NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C. PROFIT SHARING PLAN 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

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Company Name:	NORTHEAST GEORGIA SURGICAL HEALTHCARE, P.C.
Employer identification number (EIN):	202908439
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners