401k Plan data: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN plan

DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 401k Plan overview

Plan Name	DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN
Plan identification number	001

DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	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.

401k Sponsoring company profile

DAVID M. WEST, MD, PC has sponsored the creation of one or more 401k plans.

Company Name: DAVID M. WEST, MD, PC

Employer identification number (EIN): 930769251

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 DAVID M WEST
001 2011-01-01 DAVID M WEST
001 2009-01-01 DAVID M WEST

Plan id#	Filing Submission Date	Name of Administrator
001	2012-01-01	DAVID M WEST
001	2011-01-01	DAVID M WEST
001	2009-01-01	DAVID M WEST

Plan Statistics for DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN

401k plan membership statisitcs for DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN

Measure Date Value
2012: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 7
Total of all active and inactive participants 2012-01-01 0
Total participants 2012-01-01 0
2011: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 7
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 8
Total participants 2011-01-01 8
Number of participants with account balances 2011-01-01 7
2009: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 9
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 11
Total participants 2009-01-01 11
Number of participants with account balances 2009-01-01 10

Measure	Date	Value
2012: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	7
Total of all active and inactive participants	2012-01-01	0
Total participants	2012-01-01	0
2011: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	7
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	8
Total participants	2011-01-01	8
Number of participants with account balances	2011-01-01	7
2009: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	9
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	11
Total participants	2009-01-01	11
Number of participants with account balances	2009-01-01	10

Financial Data on DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN

Measure	Date	Value
2012 : DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$73,470
Expenses. Total of all expenses incurred	2012-12-31	$1,099,662
Benefits paid (including direct rollovers)	2012-12-31	$1,095,488
Total plan assets at end of year	2012-12-31	$0
Total plan assets at beginning of year	2012-12-31	$1,026,192
Value of fidelity bond covering the plan	2012-12-31	$60,000
Expenses. Other expenses not covered elsewhere	2012-12-31	$4,174
Other income received	2012-12-31	$73,470
Net income (gross income less expenses)	2012-12-31	$-1,026,192
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,026,192
2011 : DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$57,685
Expenses. Total of all expenses incurred	2011-12-31	$201,773
Benefits paid (including direct rollovers)	2011-12-31	$199,980
Total plan assets at end of year	2011-12-31	$1,026,192
Total plan assets at beginning of year	2011-12-31	$1,170,280
Value of fidelity bond covering the plan	2011-12-31	$60,000
Total contributions received or receivable from participants	2011-12-31	$31,720
Expenses. Other expenses not covered elsewhere	2011-12-31	$1,793
Other income received	2011-12-31	$12,987
Net income (gross income less expenses)	2011-12-31	$-144,088
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,026,192
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,170,280
Total contributions received or receivable from employer(s)	2011-12-31	$12,978
2010 : DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$149,404
Expenses. Total of all expenses incurred	2010-12-31	$1,804
Total plan assets at end of year	2010-12-31	$1,170,280
Total plan assets at beginning of year	2010-12-31	$1,022,680
Value of fidelity bond covering the plan	2010-12-31	$60,000
Total contributions received or receivable from participants	2010-12-31	$46,740
Expenses. Other expenses not covered elsewhere	2010-12-31	$1,804
Other income received	2010-12-31	$86,048
Net income (gross income less expenses)	2010-12-31	$147,600
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,170,280
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,022,680
Total contributions received or receivable from employer(s)	2010-12-31	$16,616

Form 5500 Responses for DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN

2012: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	This submission is the final filing	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 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 - Trust	Yes
2009: DAVID M. WEST MD PC 401 K PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	DAVID M. WEST, MD, PC
Employer identification number (EIN):	930769251
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)