401k Plan data: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN plan

RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 401k Plan overview

Plan Name	RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN
Plan identification number	002

RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing

401k Sponsoring company profile

RICHARD S. SEPESY, D.D.S., LTD. has sponsored the creation of one or more 401k plans.

Company Name: RICHARD S. SEPESY, D.D.S., LTD.

Employer identification number (EIN): 251304256

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01 RICHARD S. SEPESY, DDS RICHARD S. SEPESY, DDS 2017-01-28
002 2015-01-01 RICHARD S. SEPESY, DDS RICHARD S. SEPESY, DDS 2016-02-22
002 2014-01-01 RICHARD S. SEPESY, DDS RICHARD S. SEPESY, DDS 2015-07-27
002 2013-01-01 RICHARD S. SEPESY, DDS RICHARD S. SEPESY, DDS 2014-07-25
002 2012-01-01 RICHARD S. SEPESY, DDS RICHARD S. SEPESY, DDS 2013-07-26
002 2011-01-01 RICHARD S. SEPESY, DDS RICHARD S. SEPESY, DDS 2012-07-27
002 2010-01-01 RICHARD S. SEPESY, DDS RICHARD S. SEPESY, DDS 2011-08-01
002 2009-01-01 RICHARD S. SEPESY, DDS RICHARD S. SEPESY, DDS 2010-07-22

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2016-01-01	RICHARD S. SEPESY, DDS	RICHARD S. SEPESY, DDS	2017-01-28
002	2015-01-01	RICHARD S. SEPESY, DDS	RICHARD S. SEPESY, DDS	2016-02-22
002	2014-01-01	RICHARD S. SEPESY, DDS	RICHARD S. SEPESY, DDS	2015-07-27
002	2013-01-01	RICHARD S. SEPESY, DDS	RICHARD S. SEPESY, DDS	2014-07-25
002	2012-01-01	RICHARD S. SEPESY, DDS	RICHARD S. SEPESY, DDS	2013-07-26
002	2011-01-01	RICHARD S. SEPESY, DDS	RICHARD S. SEPESY, DDS	2012-07-27
002	2010-01-01	RICHARD S. SEPESY, DDS	RICHARD S. SEPESY, DDS	2011-08-01
002	2009-01-01	RICHARD S. SEPESY, DDS	RICHARD S. SEPESY, DDS	2010-07-22

Plan Statistics for RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN

401k plan membership statisitcs for RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN

Measure Date Value
2016: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 4
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 4
Number of participants with account balances 2015-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 4
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 4
Number of participants with account balances 2014-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 4
Number of participants with account balances 2013-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 4
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 0
Total of all active and inactive participants 2012-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 4
Number of participants with account balances 2012-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 4
Number of participants with account balances 2011-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 4
Number of participants with account balances 2010-01-01 4
2009: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 4
Number of participants with account balances 2009-01-01 4

Measure	Date	Value
2016: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	4
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	4
Number of participants with account balances	2015-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	4
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	4
Number of participants with account balances	2014-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	4
Number of participants with account balances	2013-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	4
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	0
Total of all active and inactive participants	2012-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	4
Number of participants with account balances	2012-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	4
Number of participants with account balances	2011-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	4
Number of participants with account balances	2010-01-01	4
2009: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	4
Number of participants with account balances	2009-01-01	4

Financial Data on RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN

Measure	Date	Value
2016 : RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$8,821
Expenses. Total of all expenses incurred	2016-12-31	$2,342,283
Benefits paid (including direct rollovers)	2016-12-31	$2,332,481
Total plan assets at end of year	2016-12-31	$0
Total plan assets at beginning of year	2016-12-31	$2,333,462
Value of fidelity bond covering the plan	2016-12-31	$300,000
Expenses. Other expenses not covered elsewhere	2016-12-31	$308
Other income received	2016-12-31	$8,821
Net income (gross income less expenses)	2016-12-31	$-2,333,462
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$2,333,462
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$9,494
2015 : RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$29,191
Expenses. Total of all expenses incurred	2015-12-31	$93,561
Benefits paid (including direct rollovers)	2015-12-31	$81,045
Total plan assets at end of year	2015-12-31	$2,333,462
Total plan assets at beginning of year	2015-12-31	$2,397,832
Value of fidelity bond covering the plan	2015-12-31	$300,000
Expenses. Other expenses not covered elsewhere	2015-12-31	$156
Other income received	2015-12-31	$29,191
Net income (gross income less expenses)	2015-12-31	$-64,370
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$2,333,462
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$2,397,832
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$12,360
2014 : RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$160,386
Expenses. Total of all expenses incurred	2014-12-31	$80,149
Benefits paid (including direct rollovers)	2014-12-31	$68,038
Total plan assets at end of year	2014-12-31	$2,397,832
Total plan assets at beginning of year	2014-12-31	$2,317,595
Value of fidelity bond covering the plan	2014-12-31	$300,000
Expenses. Other expenses not covered elsewhere	2014-12-31	$56
Other income received	2014-12-31	$160,386
Net income (gross income less expenses)	2014-12-31	$80,237
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,397,832
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,317,595
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$12,055
2013 : RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$307,228
Expenses. Total of all expenses incurred	2013-12-31	$75,958
Benefits paid (including direct rollovers)	2013-12-31	$65,038
Total plan assets at end of year	2013-12-31	$2,317,595
Total plan assets at beginning of year	2013-12-31	$2,086,325
Value of fidelity bond covering the plan	2013-12-31	$300,000
Other income received	2013-12-31	$307,228
Net income (gross income less expenses)	2013-12-31	$231,270
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,317,595
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$2,086,325
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$10,920
2012 : RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$267,427
Expenses. Total of all expenses incurred	2012-12-31	$64,542
Benefits paid (including direct rollovers)	2012-12-31	$54,543
Total plan assets at end of year	2012-12-31	$2,086,325
Total plan assets at beginning of year	2012-12-31	$1,883,440
Value of fidelity bond covering the plan	2012-12-31	$300,000
Other income received	2012-12-31	$267,427
Net income (gross income less expenses)	2012-12-31	$202,885
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$2,086,325
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,883,440
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$9,999
2011 : RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$12,792
Expenses. Total of all expenses incurred	2011-12-31	$65,491
Benefits paid (including direct rollovers)	2011-12-31	$56,054
Total plan assets at end of year	2011-12-31	$1,883,440
Total plan assets at beginning of year	2011-12-31	$1,936,139
Value of fidelity bond covering the plan	2011-12-31	$300,000
Other income received	2011-12-31	$12,792
Net income (gross income less expenses)	2011-12-31	$-52,699
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,883,440
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,936,139
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$9,437
2010 : RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$156,709
Expenses. Total of all expenses incurred	2010-12-31	$59,181
Benefits paid (including direct rollovers)	2010-12-31	$50,074
Total plan assets at end of year	2010-12-31	$1,936,139
Total plan assets at beginning of year	2010-12-31	$1,838,611
Value of fidelity bond covering the plan	2010-12-31	$300,000
Other income received	2010-12-31	$156,709
Net income (gross income less expenses)	2010-12-31	$97,528
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,936,139
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,838,611
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$9,107

Form 5500 Responses for RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN

2016: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	This submission is the final filing	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: RICHARD S. SEPESY, DDS, LTD. 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
2010: RICHARD S. SEPESY, DDS, LTD. PROFIT-SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: RICHARD S. SEPESY, DDS, LTD. 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:	RICHARD S. SEPESY, D.D.S., LTD.
Employer identification number (EIN):	251304256
NAIC Classification:	621210
NAIC Description:	Offices of Dentists