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SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN 401k Plan overview

Plan NameSANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN
Plan identification number 003

SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily pay related
  • Plan covering Self-Employed individuals.
  • 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

SANFORD POLSE, M.D. has sponsored the creation of one or more 401k plans.

Company Name:SANFORD POLSE, M.D.
Employer identification number (EIN):202090972
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032012-01-01SANFORD L. POLSE, M.D.

Plan Statistics for SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN

401k plan membership statisitcs for SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN

Measure Date Value
2012: SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-013
Total number of active participants reported on line 7a of the Form 55002012-01-014
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010

Financial Data on SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN

Measure Date Value
2012 : SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$115,236
Expenses. Total of all expenses incurred2012-12-31$108,494
Benefits paid (including direct rollovers)2012-12-31$102,732
Total plan assets at end of year2012-12-31$1,219,426
Total plan assets at beginning of year2012-12-31$1,212,684
Value of fidelity bond covering the plan2012-12-31$100,000
Total contributions received or receivable from participants2012-12-31$0
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$115,236
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$6,742
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,219,426
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,212,684
Assets. Value of participant loans2012-12-31$3,724
Assets. Value of real-estate (other than employer real property)2012-12-31$100,000
Total contributions received or receivable from employer(s)2012-12-31$0
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$5,762
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0

Form 5500 Responses for SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN

2012: SANFORD L. POLSE, M.D. DEFINED BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes

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