401k Plan data: M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST plan

M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan Name	M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST
Plan identification number	002

M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 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
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

M.M. DEREN, M.D., P.C. has sponsored the creation of one or more 401k plans.

Company Name: M.M. DEREN, M.D., P.C.

Employer identification number (EIN): 060905653

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-01-01 MIECRYLOW DEREN 2015-03-30 MIECRYLOW DEREN 2015-03-30
002 2014-01-01 MIECRYLOW DEREN 2015-03-30 MIECRYLOW DEREN 2015-03-30
002 2013-01-01 MIECRYLOW DEREN 2014-10-13 MIECRYLOW DEREN 2014-10-13
002 2012-01-01 MIECRYLOW DEREN 2013-10-10 MIECRYLOW DEREN 2013-10-10
002 2011-01-01 MIECRYLOW DEREN 2012-10-03
002 2010-01-01 MIECRYLOW DEREN 2011-10-10
002 2007-01-01 MIECRYLOW DEREN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2015-01-01	MIECRYLOW DEREN	2015-03-30	MIECRYLOW DEREN	2015-03-30
002	2014-01-01	MIECRYLOW DEREN	2015-03-30	MIECRYLOW DEREN	2015-03-30
002	2013-01-01	MIECRYLOW DEREN	2014-10-13	MIECRYLOW DEREN	2014-10-13
002	2012-01-01	MIECRYLOW DEREN	2013-10-10	MIECRYLOW DEREN	2013-10-10
002	2011-01-01	MIECRYLOW DEREN	2012-10-03
002	2010-01-01	MIECRYLOW DEREN	2011-10-10
002	2007-01-01	MIECRYLOW DEREN

Financial Data on M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST

Measure	Date	Value
2007 : M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2007 401k financial data
Total income from all sources	2007-12-31	$-5,837
Expenses. Total of all expenses incurred	2007-12-31	$106,297
Benefits paid (including direct rollovers)	2007-12-31	$104,937
Total plan assets at end of year	2007-12-31	$922,918
Total plan assets at beginning of year	2007-12-31	$1,035,052
Value of fidelity bond covering the plan	2007-12-31	$260,000
Expenses. Other expenses not covered elsewhere	2007-12-31	$1,360
Other income received	2007-12-31	$-5,837
Net income (gross income less expenses)	2007-12-31	$-112,134
Net plan assets at end of year (total assets less liabilities)	2007-12-31	$922,918
Net plan assets at beginning of year (total assets less liabilities)	2007-12-31	$1,035,052

Form 5500 Responses for M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST

2007: M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	Yes
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Insurance	Yes
2007-01-01	Plan funding arrangement – Trust	Yes
2007-01-01	Plan benefit arrangement – Insurance	Yes
2007-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	020050796
Policy instance	1

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Company Name:	M.M. DEREN, M.D., P.C.
Employer identification number (EIN):	060905653
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)