401k Plan data: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST plan

CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 401k Plan overview

Plan Name	CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST
Plan identification number	001

CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & 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.
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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

CHARLES D. KELLEY, D.D.S., P.C. has sponsored the creation of one or more 401k plans.

Company Name: CHARLES D. KELLEY, D.D.S., P.C.

Employer identification number (EIN): 841367678

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Additional information about CHARLES D. KELLEY, D.D.S., P.C.

Jurisdiction of Incorporation: Colorado Department of State

Incorporation Date: 2006-05-01

Company Identification Number: 20061180412

Legal Registered Office Address: 603 So. 1st Street

Lamar
United States of America (USA)
81052

More information about CHARLES D. KELLEY, D.D.S., P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 CHARLES KELLEY
001 2012-01-01 CHARLES KELLEY
001 2011-01-01 CHARLES KELLEY
001 2010-01-01 CHARLES KELLEY
001 2009-01-01 CHARLES KELLEY CHARLES KELLEY 2010-05-13

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	CHARLES KELLEY
001	2012-01-01	CHARLES KELLEY
001	2011-01-01	CHARLES KELLEY
001	2010-01-01	CHARLES KELLEY
001	2009-01-01	CHARLES KELLEY	CHARLES KELLEY	2010-05-13

Plan Statistics for CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST

401k plan membership statisitcs for CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST

Measure Date Value
2013: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 0
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 5
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 1
Total of all active and inactive participants 2012-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 6
Number of participants with account balances 2012-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 6
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 0
Total of all active and inactive participants 2011-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 6
Number of participants with account balances 2011-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 6
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 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 6
Number of participants with account balances 2010-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6
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 0
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
2013: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	0
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	5
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	1
Total of all active and inactive participants	2012-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	6
Number of participants with account balances	2012-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	6
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	0
Total of all active and inactive participants	2011-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	6
Number of participants with account balances	2011-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	6
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	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	6
Number of participants with account balances	2010-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6
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	0
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 CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST

Measure	Date	Value
2013 : CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 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	$52,497
Expenses. Total of all expenses incurred	2013-12-31	$467,763
Benefits paid (including direct rollovers)	2013-12-31	$467,763
Total plan assets at end of year	2013-12-31	$0
Total plan assets at beginning of year	2013-12-31	$415,266
Value of fidelity bond covering the plan	2013-12-31	$200,000
Total contributions received or receivable from participants	2013-12-31	$0
Other income received	2013-12-31	$47,635
Net income (gross income less expenses)	2013-12-31	$-415,266
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$415,266
Total contributions received or receivable from employer(s)	2013-12-31	$4,862
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$48,752
Expenses. Total of all expenses incurred	2012-12-31	$7,330
Benefits paid (including direct rollovers)	2012-12-31	$7,330
Total plan assets at end of year	2012-12-31	$415,266
Total plan assets at beginning of year	2012-12-31	$373,844
Value of fidelity bond covering the plan	2012-12-31	$200,000
Other income received	2012-12-31	$43,291
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$41,422
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$415,266
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$373,844
Total contributions received or receivable from employer(s)	2012-12-31	$5,461
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$371
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$373,844
Total plan assets at beginning of year	2011-12-31	$373,473
Value of fidelity bond covering the plan	2011-12-31	$200,000
Other income received	2011-12-31	$-5,812
Net income (gross income less expenses)	2011-12-31	$371
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$373,844
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$373,473
Total contributions received or receivable from employer(s)	2011-12-31	$6,183
2010 : CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 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	$0
Total income from all sources	2010-12-31	$89,190
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$373,473
Total plan assets at beginning of year	2010-12-31	$284,283
Value of fidelity bond covering the plan	2010-12-31	$200,000
Total contributions received or receivable from participants	2010-12-31	$36,269
Other income received	2010-12-31	$45,760
Net income (gross income less expenses)	2010-12-31	$89,190
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$373,473
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$284,283
Total contributions received or receivable from employer(s)	2010-12-31	$7,161
2009 : CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 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 CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST

2013: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 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	Yes
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
2012: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & 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 - Trust	Yes
2011: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 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: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 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: CHARLES D. KELLEY, D.D.S., P.C. 401(K) PLAN & TRUST 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

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Company Name:	CHARLES D. KELLEY, D.D.S., P.C.
Employer identification number (EIN):	841367678
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Jurisdiction of Incorporation:	Colorado Department of State
Incorporation Date:	2006-05-01
Company Identification Number:	20061180412
Legal Registered Office Address:	603 So. 1st Street Lamar United States of America (USA) 81052