401k Plan data: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN plan

JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 401k Plan overview

Plan Name	JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN
Plan identification number	001

JOHN R. DOSSER, M.D., INC. 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
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
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

JOHN R. DOSSER, M.D., INC. has sponsored the creation of one or more 401k plans.

Company Name: JOHN R. DOSSER, M.D., INC.

Employer identification number (EIN): 731226063

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 JOHN DOSSER
001 2015-01-01 JOHN DOSSER
001 2014-01-01 JOHN DOSSER
001 2013-01-01 JOHN DOSSER
001 2012-01-01 JOHN DOSSER
001 2011-01-01 JOHN DOSSER
001 2010-01-01 JOHN DOSSER
001 2009-01-01 JOHN DOSSER

Plan id#	Filing Submission Date	Name of Administrator
001	2016-01-01	JOHN DOSSER
001	2015-01-01	JOHN DOSSER
001	2014-01-01	JOHN DOSSER
001	2013-01-01	JOHN DOSSER
001	2012-01-01	JOHN DOSSER
001	2011-01-01	JOHN DOSSER
001	2010-01-01	JOHN DOSSER
001	2009-01-01	JOHN DOSSER

Plan Statistics for JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN

401k plan membership statisitcs for JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN

Measure Date Value
2016: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 3
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 3
Total of all active and inactive participants 2015-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 6
Number of participants with account balances 2015-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 6
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 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 6
Number of participants with account balances 2014-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 6
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 1
Total of all active and inactive participants 2013-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 7
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 1
2012: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 6
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 2
Total of all active and inactive participants 2012-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 8
Number of participants with account balances 2012-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 6
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 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 8
Number of participants with account balances 2011-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 7
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 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 7
Number of participants with account balances 2010-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 2
Total of all active and inactive participants 2009-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 6
Number of participants with account balances 2009-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2016: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	3
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	3
Total of all active and inactive participants	2015-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	6
Number of participants with account balances	2015-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	6
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	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	6
Number of participants with account balances	2014-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	6
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	1
Total of all active and inactive participants	2013-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	7
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	1
2012: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	6
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	2
Total of all active and inactive participants	2012-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	8
Number of participants with account balances	2012-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	6
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	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	8
Number of participants with account balances	2011-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	7
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	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	7
Number of participants with account balances	2010-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	2
Total of all active and inactive participants	2009-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	6
Number of participants with account balances	2009-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN

Measure	Date	Value
2016 : JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-07-31	$10,198
Expenses. Total of all expenses incurred	2016-07-31	$1,050,098
Benefits paid (including direct rollovers)	2016-07-31	$1,040,679
Total plan assets at end of year	2016-07-31	$0
Total plan assets at beginning of year	2016-07-31	$1,039,900
Value of fidelity bond covering the plan	2016-07-31	$120,000
Total contributions received or receivable from participants	2016-07-31	$0
Contributions received from other sources (not participants or employers)	2016-07-31	$0
Other income received	2016-07-31	$10,198
Net income (gross income less expenses)	2016-07-31	$-1,039,900
Net plan assets at end of year (total assets less liabilities)	2016-07-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2016-07-31	$1,039,900
Total contributions received or receivable from employer(s)	2016-07-31	$0
Value of certain deemed distributions of participant loans	2016-07-31	$9,419
2015 : JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$32,623
Expenses. Total of all expenses incurred	2015-12-31	$255,701
Benefits paid (including direct rollovers)	2015-12-31	$255,701
Total plan assets at end of year	2015-12-31	$1,039,900
Total plan assets at beginning of year	2015-12-31	$1,262,978
Value of fidelity bond covering the plan	2015-12-31	$120,000
Total contributions received or receivable from participants	2015-12-31	$33,493
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-5,523
Net income (gross income less expenses)	2015-12-31	$-223,078
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,039,900
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,262,978
Assets. Value of participant loans	2015-12-31	$9,316
Total contributions received or receivable from employer(s)	2015-12-31	$4,653
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$0
2014 : JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$90,205
Expenses. Total of all expenses incurred	2014-12-31	$400
Benefits paid (including direct rollovers)	2014-12-31	$400
Total plan assets at end of year	2014-12-31	$1,262,978
Total plan assets at beginning of year	2014-12-31	$1,173,173
Value of fidelity bond covering the plan	2014-12-31	$120,000
Total contributions received or receivable from participants	2014-12-31	$31,072
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$44,580
Net income (gross income less expenses)	2014-12-31	$89,805
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,262,978
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,173,173
Assets. Value of participant loans	2014-12-31	$17,450
Total contributions received or receivable from employer(s)	2014-12-31	$14,553
Value of certain deemed distributions of participant loans	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
2013 : JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$154,451
Expenses. Total of all expenses incurred	2013-12-31	$16,117
Benefits paid (including direct rollovers)	2013-12-31	$16,117
Total plan assets at end of year	2013-12-31	$1,173,173
Total plan assets at beginning of year	2013-12-31	$1,034,839
Total contributions received or receivable from participants	2013-12-31	$30,412
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$80,507
Net income (gross income less expenses)	2013-12-31	$138,334
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,173,173
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,034,839
Assets. Value of participant loans	2013-12-31	$14,066
Total contributions received or receivable from employer(s)	2013-12-31	$43,532
Value of certain deemed distributions of participant loans	2013-12-31	$0
2012 : JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$123,313
Expenses. Total of all expenses incurred	2012-12-31	$43,844
Benefits paid (including direct rollovers)	2012-12-31	$43,844
Total plan assets at end of year	2012-12-31	$1,034,839
Total plan assets at beginning of year	2012-12-31	$955,370
Total contributions received or receivable from participants	2012-12-31	$27,996
Other income received	2012-12-31	$41,526
Net income (gross income less expenses)	2012-12-31	$79,469
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,034,839
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$955,370
Assets. Value of participant loans	2012-12-31	$21,764
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2012-12-31	$14,090
Total contributions received or receivable from employer(s)	2012-12-31	$53,791
2011 : JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$36,023
Expenses. Total of all expenses incurred	2011-12-31	$8,726
Total plan assets at end of year	2011-12-31	$955,370
Total plan assets at beginning of year	2011-12-31	$928,073
Total contributions received or receivable from participants	2011-12-31	$31,404
Expenses. Other expenses not covered elsewhere	2011-12-31	$8,726
Other income received	2011-12-31	$-47,223
Net income (gross income less expenses)	2011-12-31	$27,297
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$955,370
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$928,073
Assets. Value of participant loans	2011-12-31	$13,618
Total contributions received or receivable from employer(s)	2011-12-31	$51,842
2010 : JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$180
Total income from all sources	2010-12-31	$112,479
Expenses. Total of all expenses incurred	2010-12-31	$6,980
Benefits paid (including direct rollovers)	2010-12-31	$88
Total plan assets at end of year	2010-12-31	$928,073
Total plan assets at beginning of year	2010-12-31	$822,754
Total contributions received or receivable from participants	2010-12-31	$32,160
Expenses. Other expenses not covered elsewhere	2010-12-31	$6,892
Other income received	2010-12-31	$26,802
Net income (gross income less expenses)	2010-12-31	$105,499
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$928,073
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$822,574
Total contributions received or receivable from employer(s)	2010-12-31	$53,517
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN

2016: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	This submission is the final filing	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: JOHN R. DOSSER, M.D., INC. 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: JOHN R. DOSSER, M.D., INC. 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
2009: JOHN R. DOSSER, M.D., INC. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

713708

Policy instance

Insurance contract or identification number	713708
Number of Individuals Covered	0
Total amount of commissions paid to insurance broker	USD $80
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $80
Insurance broker organization code?	3
Insurance broker name	REGAL SECURITIES INC

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Company Name:	JOHN R. DOSSER, M.D., INC.
Employer identification number (EIN):	731226063
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)