401k Plan data: PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A. plan

PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A. 401k Plan overview

Plan Name	PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A.
Plan identification number	002

PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A. Benefits

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

PIEDMONT ORAL SURGERY, P.A. has sponsored the creation of one or more 401k plans.

Company Name: PIEDMONT ORAL SURGERY, P.A.

Employer identification number (EIN): 570526127

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-01-01 LARRY COBB, DMD 2015-09-22
002 2014-01-01 LARRY COBB, DMD
002 2013-01-01 LARRY COBB, DMD
002 2012-01-01 LARRY COBB, DMD 2013-05-08
002 2011-01-01 LARRY COBB, DMD 2012-05-02
002 2010-01-01 LARRY COBB, DMD 2011-04-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2015-01-01	LARRY COBB, DMD	2015-09-22
002	2014-01-01	LARRY COBB, DMD
002	2013-01-01	LARRY COBB, DMD
002	2012-01-01	LARRY COBB, DMD	2013-05-08
002	2011-01-01	LARRY COBB, DMD	2012-05-02
002	2010-01-01	LARRY COBB, DMD	2011-04-27

Plan Statistics for PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A.

401k plan membership statisitcs for PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A.

Measure Date Value
2014: PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A. 2014 401k membership
Total participants, beginning-of-year 2014-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
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 AND TRUST OF PIEDMONT ORAL SURGERY, P.A. 2013 401k membership
Total participants, beginning-of-year 2013-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 8
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 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 8
Number of participants with account balances 2013-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0

Measure	Date	Value
2014: PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A. 2014 401k membership
Total participants, beginning-of-year	2014-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
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 AND TRUST OF PIEDMONT ORAL SURGERY, P.A. 2013 401k membership
Total participants, beginning-of-year	2013-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	8
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	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	8
Number of participants with account balances	2013-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0

Financial Data on PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A.

Measure	Date	Value
2014 : PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A. 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$184,747
Expenses. Total of all expenses incurred	2014-12-31	$4,980,607
Benefits paid (including direct rollovers)	2014-12-31	$4,960,714
Total plan assets at end of year	2014-12-31	$2,967
Total plan assets at beginning of year	2014-12-31	$4,798,827
Value of fidelity bond covering the plan	2014-12-31	$500,000
Other income received	2014-12-31	$184,747
Net income (gross income less expenses)	2014-12-31	$-4,795,860
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,967
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$4,798,827
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$19,893
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A. 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$508,004
Expenses. Total of all expenses incurred	2013-12-31	$240,716
Benefits paid (including direct rollovers)	2013-12-31	$198,000
Total plan assets at end of year	2013-12-31	$4,798,827
Total plan assets at beginning of year	2013-12-31	$4,531,539
Value of fidelity bond covering the plan	2013-12-31	$500,000
Other income received	2013-12-31	$508,004
Net income (gross income less expenses)	2013-12-31	$267,288
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$4,798,827
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$4,531,539
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$292,719
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$42,716
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0

Form 5500 Responses for PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A.

2014: PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A. 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PROFIT-SHARING PLAN AND TRUST OF PIEDMONT ORAL SURGERY, P.A. 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	PIEDMONT ORAL SURGERY, P.A.
Employer identification number (EIN):	570526127
NAIC Classification:	621210
NAIC Description:	Offices of Dentists