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| Plan Name | LAKE SHORE GASTROENTEROLOGY SC EMPLOYEES' PROFIT SHARING PLAN |
| Plan identification number | 002 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | LAKE SHORE GASTROENTEROLOGY SC |
| Employer identification number (EIN): | 363029837 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 002 | 2011-07-01 | KEVIN LIEBOVICH, MD | 2012-09-25 |
| Measure | Date | Value |
|---|---|---|
| 2011 : LAKE SHORE GASTROENTEROLOGY SC EMPLOYEES' PROFIT SHARING PLAN 2011 401k financial data | ||
| Total income from all sources | 2011-06-30 | $1,378,979 |
| Expenses. Total of all expenses incurred | 2011-06-30 | $21,647 |
| Benefits paid (including direct rollovers) | 2011-06-30 | $21,647 |
| Total plan assets at end of year | 2011-06-30 | $7,498,245 |
| Total plan assets at beginning of year | 2011-06-30 | $6,140,913 |
| Value of fidelity bond covering the plan | 2011-06-30 | $500,000 |
| Total contributions received or receivable from participants | 2011-06-30 | $127,228 |
| Other income received | 2011-06-30 | $956,167 |
| Net income (gross income less expenses) | 2011-06-30 | $1,357,332 |
| Net plan assets at end of year (total assets less liabilities) | 2011-06-30 | $7,498,245 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-06-30 | $6,140,913 |
| Assets. Value of participant loans | 2011-06-30 | $21,634 |
| Assets. Value of real-estate (other than employer real property) | 2011-06-30 | $600,000 |
| Total contributions received or receivable from employer(s) | 2011-06-30 | $295,584 |
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