401k Plan data: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN plan

CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 401k Plan overview

Plan Name	CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN
Plan identification number	001

CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
Total participant-directed account plan - Participants have the opportunity to direct the investment of all 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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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

CRISTON C. CLARK, D.M.D., LLC has sponsored the creation of one or more 401k plans.

Company Name: CRISTON C. CLARK, D.M.D., LLC

Employer identification number (EIN): 300059037

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 CRISTON C. CLARK, D.M.D., LLC CRISTON C. CLARK, D.M.D., LLC 2013-07-31
001 2012-01-01 CRISTON C. CLARK, D.M.D., LLC CRISTON C. CLARK, D.M.D., LLC 2013-07-31
001 2011-01-01 CRISTON C. CLARK CRISTON C. CLARK 2012-10-10
001 2009-01-01 CRISTON CLARK CRISTON CLARK 2010-10-01

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	CRISTON C. CLARK, D.M.D., LLC	CRISTON C. CLARK, D.M.D., LLC	2013-07-31
001	2012-01-01	CRISTON C. CLARK, D.M.D., LLC	CRISTON C. CLARK, D.M.D., LLC	2013-07-31
001	2011-01-01	CRISTON C. CLARK	CRISTON C. CLARK	2012-10-10
001	2009-01-01	CRISTON CLARK	CRISTON CLARK	2010-10-01

Plan Statistics for CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN

401k plan membership statisitcs for CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN

Measure Date Value
2013: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Total of all active and inactive participants 2013-01-01 0
Total participants 2013-01-01 0
Number of participants with account balances 2013-01-01 0
2012: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2
Total of all active and inactive participants 2012-01-01 2
Total participants 2012-01-01 2
Number of participants with account balances 2012-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 5
Total of all active and inactive participants 2011-01-01 5
Total participants 2011-01-01 5
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
2009: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
Total of all active and inactive participants 2009-01-01 4
Total participants 2009-01-01 4
Number of participants with account balances 2009-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2013: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Total of all active and inactive participants	2013-01-01	0
Total participants	2013-01-01	0
Number of participants with account balances	2013-01-01	0
2012: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2
Total of all active and inactive participants	2012-01-01	2
Total participants	2012-01-01	2
Number of participants with account balances	2012-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	5
Total of all active and inactive participants	2011-01-01	5
Total participants	2011-01-01	5
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
2009: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
Total of all active and inactive participants	2009-01-01	4
Total participants	2009-01-01	4
Number of participants with account balances	2009-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN

Measure	Date	Value
2013 : CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-05-09	$2,554
Expenses. Total of all expenses incurred	2013-05-09	$36,663
Benefits paid (including direct rollovers)	2013-05-09	$35,223
Total plan assets at end of year	2013-05-09	$0
Total plan assets at beginning of year	2013-05-09	$34,109
Expenses. Other expenses not covered elsewhere	2013-05-09	$1,440
Other income received	2013-05-09	$2,554
Net income (gross income less expenses)	2013-05-09	$-34,109
Net plan assets at end of year (total assets less liabilities)	2013-05-09	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-05-09	$34,109
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2013-05-09	$1,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-05-09	$0
2012 : CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$7,989
Expenses. Total of all expenses incurred	2012-12-31	$48,405
Benefits paid (including direct rollovers)	2012-12-31	$48,405
Total plan assets at end of year	2012-12-31	$34,109
Total plan assets at beginning of year	2012-12-31	$74,525
Total contributions received or receivable from participants	2012-12-31	$596
Other income received	2012-12-31	$6,916
Net income (gross income less expenses)	2012-12-31	$-40,416
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$34,109
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$74,525
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2012-12-31	$1,000
Total contributions received or receivable from employer(s)	2012-12-31	$477
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$13,627
Expenses. Total of all expenses incurred	2011-12-31	$6,223
Benefits paid (including direct rollovers)	2011-12-31	$6,223
Total plan assets at end of year	2011-12-31	$74,525
Total plan assets at beginning of year	2011-12-31	$67,121
Total contributions received or receivable from participants	2011-12-31	$11,326
Other income received	2011-12-31	$-981
Net income (gross income less expenses)	2011-12-31	$7,404
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$74,525
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$67,121
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2011-12-31	$1,000
Total contributions received or receivable from employer(s)	2011-12-31	$3,282
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$32,064
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$67,121
Total plan assets at beginning of year	2010-12-31	$35,057
Total contributions received or receivable from participants	2010-12-31	$19,346
Other income received	2010-12-31	$5,869
Net income (gross income less expenses)	2010-12-31	$32,064
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$67,121
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$35,057
Total contributions received or receivable from employer(s)	2010-12-31	$6,849

Form 5500 Responses for CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN

2013: CRISTON C. CLARK, D.M.D., LLC 401(K) 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	Yes
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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
2012: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CRISTON C. CLARK, D.M.D., LLC 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	CRISTON C. CLARK, D.M.D., LLC
Employer identification number (EIN):	300059037
NAIC Classification:	621210
NAIC Description:	Offices of Dentists