401k Plan data: MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN plan

MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN
Plan identification number	001

MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

MARK H. BLAISDELL, D.D.S., P.C. has sponsored the creation of one or more 401k plans.

Company Name: MARK H. BLAISDELL, D.D.S., P.C.

Employer identification number (EIN): 870401770

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01 MARK H. BLAISDELL, D.D.S 2021-02-24
001 2019-01-01 MARK H. BLAISDELL, D.D.S 2020-06-02
001 2018-01-01
001 2017-01-01
001 2016-01-01 MARK H. BLAISDELL, D.D.S
001 2015-01-01 MARK H. BLAISDELL, D.D.S
001 2014-01-01 MARK H. BLAISDELL
001 2013-01-01 MARK H. BLAISDELL
001 2012-01-01 MARK H. BLAISDELL 2013-06-20
001 2011-01-01 MARK H. BLAISDELL 2012-10-11
001 2010-01-01 MARK H. BLAISDELL 2011-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2020-01-01	MARK H. BLAISDELL, D.D.S	2021-02-24
001	2019-01-01	MARK H. BLAISDELL, D.D.S	2020-06-02
001	2018-01-01
001	2017-01-01
001	2016-01-01	MARK H. BLAISDELL, D.D.S
001	2015-01-01	MARK H. BLAISDELL, D.D.S
001	2014-01-01	MARK H. BLAISDELL
001	2013-01-01	MARK H. BLAISDELL
001	2012-01-01	MARK H. BLAISDELL	2013-06-20
001	2011-01-01	MARK H. BLAISDELL	2012-10-11
001	2010-01-01	MARK H. BLAISDELL	2011-10-13

Financial Data on MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2020 : MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$63,452
Expenses. Total of all expenses incurred	2020-12-31	$1,491,443
Benefits paid (including direct rollovers)	2020-12-31	$1,479,854
Total plan assets at end of year	2020-12-31	$91,409
Total plan assets at beginning of year	2020-12-31	$1,519,400
Value of fidelity bond covering the plan	2020-12-31	$320,000
Other income received	2020-12-31	$63,452
Net income (gross income less expenses)	2020-12-31	$-1,427,991
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$91,409
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$1,519,400
Assets. Value of real-estate (other than employer real property)	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$11,589
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$261,468
Expenses. Total of all expenses incurred	2019-12-31	$36,938
Benefits paid (including direct rollovers)	2019-12-31	$25,000
Total plan assets at end of year	2019-12-31	$1,519,400
Total plan assets at beginning of year	2019-12-31	$1,294,870
Value of fidelity bond covering the plan	2019-12-31	$320,000
Total contributions received or receivable from participants	2019-12-31	$12,583
Other income received	2019-12-31	$190,036
Net income (gross income less expenses)	2019-12-31	$224,530
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$1,519,400
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$1,294,870
Assets. Value of real-estate (other than employer real property)	2019-12-31	$122,000
Total contributions received or receivable from employer(s)	2019-12-31	$58,849
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$11,938
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$-178,525
Expenses. Total of all expenses incurred	2018-12-31	$11,624
Total plan assets at end of year	2018-12-31	$1,294,870
Total plan assets at beginning of year	2018-12-31	$1,485,019
Value of fidelity bond covering the plan	2018-12-31	$320,000
Total contributions received or receivable from participants	2018-12-31	$7,074
Other income received	2018-12-31	$-188,151
Net income (gross income less expenses)	2018-12-31	$-190,149
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$1,294,870
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$1,485,019
Assets. Value of real-estate (other than employer real property)	2018-12-31	$104,000
Total contributions received or receivable from employer(s)	2018-12-31	$2,552
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$11,624
2017 : MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$119,048
Expenses. Total of all expenses incurred	2017-12-31	$11,180
Total plan assets at end of year	2017-12-31	$1,485,019
Total plan assets at beginning of year	2017-12-31	$1,377,151
Value of fidelity bond covering the plan	2017-12-31	$320,000
Total contributions received or receivable from participants	2017-12-31	$2,434
Other income received	2017-12-31	$109,127
Net income (gross income less expenses)	2017-12-31	$107,868
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$1,485,019
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$1,377,151
Assets. Value of real-estate (other than employer real property)	2017-12-31	$229,561
Total contributions received or receivable from employer(s)	2017-12-31	$7,487
Value of certain deemed distributions of participant loans	2017-12-31	$11,180
2016 : MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$61,756
Expenses. Total of all expenses incurred	2016-12-31	$18,141
Benefits paid (including direct rollovers)	2016-12-31	$7,401
Total plan assets at end of year	2016-12-31	$1,377,151
Total plan assets at beginning of year	2016-12-31	$1,333,536
Value of fidelity bond covering the plan	2016-12-31	$320,000
Total contributions received or receivable from participants	2016-12-31	$2,704
Other income received	2016-12-31	$49,772
Net income (gross income less expenses)	2016-12-31	$43,615
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$1,377,151
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$1,333,536
Assets. Value of real-estate (other than employer real property)	2016-12-31	$229,561
Total contributions received or receivable from employer(s)	2016-12-31	$9,280
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$10,740
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at beginning of year	2015-12-31	$1,441
Total income from all sources	2015-12-31	$31,229
Expenses. Total of all expenses incurred	2015-12-31	$11,315
Total plan assets at end of year	2015-12-31	$1,333,536
Total plan assets at beginning of year	2015-12-31	$1,315,063
Value of fidelity bond covering the plan	2015-12-31	$320,000
Total contributions received or receivable from participants	2015-12-31	$47,703
Other income received	2015-12-31	$-25,522
Net income (gross income less expenses)	2015-12-31	$19,914
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,333,536
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,313,622
Assets. Value of real-estate (other than employer real property)	2015-12-31	$222,156
Total contributions received or receivable from employer(s)	2015-12-31	$9,048
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$11,315
2014 : MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$1,441
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$38,910
Expenses. Total of all expenses incurred	2014-12-31	$14,768
Benefits paid (including direct rollovers)	2014-12-31	$1,627
Total plan assets at end of year	2014-12-31	$1,315,063
Total plan assets at beginning of year	2014-12-31	$1,289,480
Value of fidelity bond covering the plan	2014-12-31	$150,000
Total contributions received or receivable from participants	2014-12-31	$7,262
Other income received	2014-12-31	$23,098
Net income (gross income less expenses)	2014-12-31	$24,142
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,313,622
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,289,480
Assets. Value of real-estate (other than employer real property)	2014-12-31	$192,535
Total contributions received or receivable from employer(s)	2014-12-31	$8,550
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$13,141
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
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	$125,143
Expenses. Total of all expenses incurred	2013-12-31	$10,921
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$1,289,480
Total plan assets at beginning of year	2013-12-31	$1,175,258
Value of fidelity bond covering the plan	2013-12-31	$150,000
Total contributions received or receivable from participants	2013-12-31	$2,417
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$114,079
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$114,222
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,289,480
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,175,258
Assets. Value of real-estate (other than employer real property)	2013-12-31	$192,535
Total contributions received or receivable from employer(s)	2013-12-31	$8,647
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$10,921
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 MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN

2020: MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 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: MARK H. BLAISDELL, D. D. S. , P. C. 401(K) PROFIT SHARING PLAN 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:	MARK H. BLAISDELL, D.D.S., P.C.
Employer identification number (EIN):	870401770
NAIC Classification:	621210
NAIC Description:	Offices of Dentists