401k Plan data: PROFIT SHARING PLAN AND TRUST plan

PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	PROFIT SHARING PLAN AND TRUST
Plan identification number	002

PROFIT SHARING PLAN AND TRUST Benefits

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

401k Sponsoring company profile

FREEBORN RADIOLOGY PA has sponsored the creation of one or more 401k plans.

Company Name: FREEBORN RADIOLOGY PA

Employer identification number (EIN): 411385598

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 ANDREA BURNS
002 2011-01-01 EZZAT MIKHAIL
002 2010-01-01 EZZAT MIKHAIL

Plan id#	Filing Submission Date	Name of Administrator
002	2012-01-01	ANDREA BURNS
002	2011-01-01	EZZAT MIKHAIL
002	2010-01-01	EZZAT MIKHAIL

Plan Statistics for PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for PROFIT SHARING PLAN AND TRUST

Measure Date Value
2012: PROFIT SHARING PLAN AND TRUST 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 0
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 AND TRUST 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
Total of all active and inactive participants 2011-01-01 2
Total participants 2011-01-01 2
2010: PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 2
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 0
Total of all active and inactive participants 2010-01-01 2
Total participants 2010-01-01 2

Measure	Date	Value
2012: PROFIT SHARING PLAN AND TRUST 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	0
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 AND TRUST 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
Total of all active and inactive participants	2011-01-01	2
Total participants	2011-01-01	2
2010: PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	2
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	0
Total of all active and inactive participants	2010-01-01	2
Total participants	2010-01-01	2

Financial Data on PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2012 : PROFIT SHARING PLAN AND TRUST 2012 401k financial data
Total plan assets at end of year	2012-12-31	$176,346
Total plan assets at beginning of year	2012-12-31	$245,256
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$176,346
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$245,256
2011 : PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Total income from all sources	2011-12-31	$0
Expenses. Total of all expenses incurred	2011-12-31	$0
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$245,256
Total plan assets at beginning of year	2011-12-31	$267,665
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Other income received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$0
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$245,256
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$267,665
Assets. Value of real-estate (other than employer real property)	2011-12-31	$232,478
Total contributions received or receivable from employer(s)	2011-12-31	$0
2010 : PROFIT SHARING PLAN AND TRUST 2010 401k financial data
Total income from all sources	2010-12-31	$0
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$267,665
Total plan assets at beginning of year	2010-12-31	$357,017
Total contributions received or receivable from participants	2010-12-31	$0
Other income received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$0
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$267,665
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$357,017
Assets. Value of real-estate (other than employer real property)	2010-12-31	$247,278
Assets. Value of employer securities	2010-12-31	$20,387
Total contributions received or receivable from employer(s)	2010-12-31	$0

Form 5500 Responses for PROFIT SHARING PLAN AND TRUST

2012: PROFIT SHARING PLAN AND TRUST 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	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: PROFIT SHARING PLAN AND TRUST 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 – Insurance	Yes
2010: PROFIT SHARING PLAN AND TRUST 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	FREEBORN RADIOLOGY PA
Employer identification number (EIN):	411385598
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)