401k Plan data: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION plan

FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 401k Plan overview

Plan Name	FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION
Plan identification number	002

FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Money purchase (other than target benefit) 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

FOX VALLEY NEUROLOGY, P.C. has sponsored the creation of one or more 401k plans.

Company Name: FOX VALLEY NEUROLOGY, P.C.

Employer identification number (EIN): 362754897

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-12-01 DR. WAYNE GAVINO DR. WAYNE GAVINO 2017-02-10
002 2014-12-01 DR. WAYNE GAVINO DR. WAYNE GAVINO 2016-08-12
002 2013-12-01 DR. WAYNE GAVINO DR. WAYNE GAVINO 2015-03-30
002 2012-12-01 DR. WAYNE GAVINO DR. WAYNE GAVINO 2014-08-28
002 2011-12-01 DR. WAYNE GAVINO DR. WAYNE GAVINO 2013-08-26
002 2010-12-01 DR. WAYNE GAVINO DR. WAYNE GAVINO 2012-09-10
002 2009-12-01 DR. WAYNE GAVINO DR. WAYNE GAVINO 2011-09-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2015-12-01	DR. WAYNE GAVINO	DR. WAYNE GAVINO	2017-02-10
002	2014-12-01	DR. WAYNE GAVINO	DR. WAYNE GAVINO	2016-08-12
002	2013-12-01	DR. WAYNE GAVINO	DR. WAYNE GAVINO	2015-03-30
002	2012-12-01	DR. WAYNE GAVINO	DR. WAYNE GAVINO	2014-08-28
002	2011-12-01	DR. WAYNE GAVINO	DR. WAYNE GAVINO	2013-08-26
002	2010-12-01	DR. WAYNE GAVINO	DR. WAYNE GAVINO	2012-09-10
002	2009-12-01	DR. WAYNE GAVINO	DR. WAYNE GAVINO	2011-09-14

Plan Statistics for FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION

401k plan membership statisitcs for FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION

Measure Date Value
2015: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2015 401k membership
Total participants, beginning-of-year 2015-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2015-12-01 0
Number of retired or separated participants receiving benefits 2015-12-01 0
Number of other retired or separated participants entitled to future benefits 2015-12-01 0
Total of all active and inactive participants 2015-12-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-12-01 0
Total participants 2015-12-01 0
Number of participants with account balances 2015-12-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-12-01 0
2014: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2014 401k membership
Total participants, beginning-of-year 2014-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2014-12-01 3
Number of retired or separated participants receiving benefits 2014-12-01 0
Number of other retired or separated participants entitled to future benefits 2014-12-01 0
Total of all active and inactive participants 2014-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-12-01 0
Total participants 2014-12-01 3
Number of participants with account balances 2014-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-12-01 0
2013: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2013 401k membership
Total participants, beginning-of-year 2013-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2013-12-01 3
Number of retired or separated participants receiving benefits 2013-12-01 0
Number of other retired or separated participants entitled to future benefits 2013-12-01 0
Total of all active and inactive participants 2013-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-12-01 0
Total participants 2013-12-01 3
Number of participants with account balances 2013-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-12-01 0
2012: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2012 401k membership
Total participants, beginning-of-year 2012-12-01 4
Total number of active participants reported on line 7a of the Form 5500 2012-12-01 3
Number of retired or separated participants receiving benefits 2012-12-01 0
Number of other retired or separated participants entitled to future benefits 2012-12-01 0
Total of all active and inactive participants 2012-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-12-01 0
Total participants 2012-12-01 3
Number of participants with account balances 2012-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-12-01 0
2011: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2011 401k membership
Total participants, beginning-of-year 2011-12-01 4
Total number of active participants reported on line 7a of the Form 5500 2011-12-01 4
Number of retired or separated participants receiving benefits 2011-12-01 0
Number of other retired or separated participants entitled to future benefits 2011-12-01 0
Total of all active and inactive participants 2011-12-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-12-01 0
Total participants 2011-12-01 4
Number of participants with account balances 2011-12-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-12-01 0
2010: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2010 401k membership
Total participants, beginning-of-year 2010-12-01 4
Total number of active participants reported on line 7a of the Form 5500 2010-12-01 4
Number of retired or separated participants receiving benefits 2010-12-01 0
Number of other retired or separated participants entitled to future benefits 2010-12-01 0
Total of all active and inactive participants 2010-12-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-12-01 0
Total participants 2010-12-01 4
Number of participants with account balances 2010-12-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-12-01 0
2009: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2009 401k membership
Total participants, beginning-of-year 2009-12-01 4
Total number of active participants reported on line 7a of the Form 5500 2009-12-01 4
Number of retired or separated participants receiving benefits 2009-12-01 0
Number of other retired or separated participants entitled to future benefits 2009-12-01 0
Total of all active and inactive participants 2009-12-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-12-01 0
Total participants 2009-12-01 4
Number of participants with account balances 2009-12-01 4

Measure	Date	Value
2015: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2015 401k membership
Total participants, beginning-of-year	2015-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2015-12-01	0
Number of retired or separated participants receiving benefits	2015-12-01	0
Number of other retired or separated participants entitled to future benefits	2015-12-01	0
Total of all active and inactive participants	2015-12-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-12-01	0
Total participants	2015-12-01	0
Number of participants with account balances	2015-12-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-12-01	0
2014: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2014 401k membership
Total participants, beginning-of-year	2014-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2014-12-01	3
Number of retired or separated participants receiving benefits	2014-12-01	0
Number of other retired or separated participants entitled to future benefits	2014-12-01	0
Total of all active and inactive participants	2014-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-12-01	0
Total participants	2014-12-01	3
Number of participants with account balances	2014-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-12-01	0
2013: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2013 401k membership
Total participants, beginning-of-year	2013-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2013-12-01	3
Number of retired or separated participants receiving benefits	2013-12-01	0
Number of other retired or separated participants entitled to future benefits	2013-12-01	0
Total of all active and inactive participants	2013-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-12-01	0
Total participants	2013-12-01	3
Number of participants with account balances	2013-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-12-01	0
2012: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2012 401k membership
Total participants, beginning-of-year	2012-12-01	4
Total number of active participants reported on line 7a of the Form 5500	2012-12-01	3
Number of retired or separated participants receiving benefits	2012-12-01	0
Number of other retired or separated participants entitled to future benefits	2012-12-01	0
Total of all active and inactive participants	2012-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-12-01	0
Total participants	2012-12-01	3
Number of participants with account balances	2012-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-12-01	0
2011: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2011 401k membership
Total participants, beginning-of-year	2011-12-01	4
Total number of active participants reported on line 7a of the Form 5500	2011-12-01	4
Number of retired or separated participants receiving benefits	2011-12-01	0
Number of other retired or separated participants entitled to future benefits	2011-12-01	0
Total of all active and inactive participants	2011-12-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-12-01	0
Total participants	2011-12-01	4
Number of participants with account balances	2011-12-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-12-01	0
2010: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2010 401k membership
Total participants, beginning-of-year	2010-12-01	4
Total number of active participants reported on line 7a of the Form 5500	2010-12-01	4
Number of retired or separated participants receiving benefits	2010-12-01	0
Number of other retired or separated participants entitled to future benefits	2010-12-01	0
Total of all active and inactive participants	2010-12-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-12-01	0
Total participants	2010-12-01	4
Number of participants with account balances	2010-12-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-12-01	0
2009: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2009 401k membership
Total participants, beginning-of-year	2009-12-01	4
Total number of active participants reported on line 7a of the Form 5500	2009-12-01	4
Number of retired or separated participants receiving benefits	2009-12-01	0
Number of other retired or separated participants entitled to future benefits	2009-12-01	0
Total of all active and inactive participants	2009-12-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-12-01	0
Total participants	2009-12-01	4
Number of participants with account balances	2009-12-01	4

Financial Data on FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION

Measure	Date	Value
2016 : FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2016 401k financial data
Transfers to/from the plan	2016-07-14	$-43,010
Total income from all sources	2016-07-14	$2,214
Total plan assets at end of year	2016-07-14	$0
Total plan assets at beginning of year	2016-07-14	$40,796
Other income received	2016-07-14	$2,214
Net income (gross income less expenses)	2016-07-14	$2,214
Net plan assets at end of year (total assets less liabilities)	2016-07-14	$0
Net plan assets at beginning of year (total assets less liabilities)	2016-07-14	$40,796
2015 : FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2015 401k financial data
Transfers to/from the plan	2015-11-30	$-896,115
Total income from all sources	2015-11-30	$4,494
Expenses. Total of all expenses incurred	2015-11-30	$1,636
Total plan assets at end of year	2015-11-30	$40,796
Total plan assets at beginning of year	2015-11-30	$934,053
Expenses. Other expenses not covered elsewhere	2015-11-30	$1,636
Other income received	2015-11-30	$1,482
Net income (gross income less expenses)	2015-11-30	$2,858
Net plan assets at end of year (total assets less liabilities)	2015-11-30	$40,796
Net plan assets at beginning of year (total assets less liabilities)	2015-11-30	$934,053
Total contributions received or receivable from employer(s)	2015-11-30	$3,012
2014 : FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2014 401k financial data
Total income from all sources	2014-11-30	$97,890
Expenses. Total of all expenses incurred	2014-11-30	$13,138
Benefits paid (including direct rollovers)	2014-11-30	$1,067
Total plan assets at end of year	2014-11-30	$934,053
Total plan assets at beginning of year	2014-11-30	$849,301
Expenses. Other expenses not covered elsewhere	2014-11-30	$12,071
Other income received	2014-11-30	$92,595
Net income (gross income less expenses)	2014-11-30	$84,752
Net plan assets at end of year (total assets less liabilities)	2014-11-30	$934,053
Net plan assets at beginning of year (total assets less liabilities)	2014-11-30	$849,301
Total contributions received or receivable from employer(s)	2014-11-30	$5,295
2013 : FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2013 401k financial data
Total income from all sources	2013-11-30	$160,138
Expenses. Total of all expenses incurred	2013-11-30	$25,871
Benefits paid (including direct rollovers)	2013-11-30	$16,132
Total plan assets at end of year	2013-11-30	$849,301
Total plan assets at beginning of year	2013-11-30	$715,034
Other income received	2013-11-30	$154,014
Net income (gross income less expenses)	2013-11-30	$134,267
Net plan assets at end of year (total assets less liabilities)	2013-11-30	$849,301
Net plan assets at beginning of year (total assets less liabilities)	2013-11-30	$715,034
Total contributions received or receivable from employer(s)	2013-11-30	$6,124
Expenses. Administrative service providers (salaries,fees and commissions)	2013-11-30	$9,739
2012 : FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2012 401k financial data
Total income from all sources	2012-11-30	$85,427
Expenses. Total of all expenses incurred	2012-11-30	$27,741
Benefits paid (including direct rollovers)	2012-11-30	$18,941
Total plan assets at end of year	2012-11-30	$715,034
Total plan assets at beginning of year	2012-11-30	$657,348
Other income received	2012-11-30	$76,108
Net income (gross income less expenses)	2012-11-30	$57,686
Net plan assets at end of year (total assets less liabilities)	2012-11-30	$715,034
Net plan assets at beginning of year (total assets less liabilities)	2012-11-30	$657,348
Total contributions received or receivable from employer(s)	2012-11-30	$9,319
Expenses. Administrative service providers (salaries,fees and commissions)	2012-11-30	$8,800
2011 : FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2011 401k financial data
Total income from all sources	2011-11-30	$31,794
Expenses. Total of all expenses incurred	2011-11-30	$24,587
Benefits paid (including direct rollovers)	2011-11-30	$3,424
Total plan assets at end of year	2011-11-30	$657,347
Total plan assets at beginning of year	2011-11-30	$650,140
Expenses. Other expenses not covered elsewhere	2011-11-30	$1,900
Other income received	2011-11-30	$23,633
Net income (gross income less expenses)	2011-11-30	$7,207
Net plan assets at end of year (total assets less liabilities)	2011-11-30	$657,347
Net plan assets at beginning of year (total assets less liabilities)	2011-11-30	$650,140
Total contributions received or receivable from employer(s)	2011-11-30	$8,161
Expenses. Administrative service providers (salaries,fees and commissions)	2011-11-30	$19,263

Form 5500 Responses for FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION

2015: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2015 form 5500 responses
2015-12-01	Type of plan entity	Single employer plan
2015-12-01	This submission is the final filing	Yes
2015-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-12-01	Plan funding arrangement – Trust	Yes
2015-12-01	Plan benefit arrangement - Trust	Yes
2014: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2014 form 5500 responses
2014-12-01	Type of plan entity	Single employer plan
2014-12-01	Plan funding arrangement – Trust	Yes
2014-12-01	Plan benefit arrangement - Trust	Yes
2013: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2013 form 5500 responses
2013-12-01	Type of plan entity	Single employer plan
2013-12-01	Plan funding arrangement – Trust	Yes
2013-12-01	Plan benefit arrangement - Trust	Yes
2012: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2012 form 5500 responses
2012-12-01	Type of plan entity	Single employer plan
2012-12-01	Plan funding arrangement – Trust	Yes
2012-12-01	Plan benefit arrangement - Trust	Yes
2011: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2011 form 5500 responses
2011-12-01	Type of plan entity	Single employer plan
2011-12-01	Plan funding arrangement – Trust	Yes
2011-12-01	Plan benefit arrangement - Trust	Yes
2010: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2010 form 5500 responses
2010-12-01	Type of plan entity	Single employer plan
2010-12-01	Plan funding arrangement – Trust	Yes
2010-12-01	Plan benefit arrangement - Trust	Yes
2009: FOX VALLEY NEUROLOGY P.C. MONEY PURCHASE PENSION 2009 form 5500 responses
2009-12-01	Type of plan entity	Single employer plan
2009-12-01	Plan funding arrangement – Trust	Yes
2009-12-01	Plan benefit arrangement - Trust	Yes

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Company Name:	FOX VALLEY NEUROLOGY, P.C.
Employer identification number (EIN):	362754897
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)