401k Plan data: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST plan

DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST
Plan identification number	002

DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 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.
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

SIZEMORE, DAVID JR., M.D., A PROFESSIONAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: SIZEMORE, DAVID JR., M.D., A PROFESSIONAL CORPORATION

Employer identification number (EIN): 330049973

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 SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2014-01-01 DAVID SIZEMORE 2015-01-08
002 2013-01-01 DAVID SIZEMORE
002 2012-01-01 DAVID SIZEMORE
002 2011-01-01 DAVID SIZEMORE
002 2010-01-01 DAVID A. SIZEMORE JR.
002 2009-01-01 DAVID A. SIZEMORE JR.

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2014-01-01	DAVID SIZEMORE	2015-01-08
002	2013-01-01	DAVID SIZEMORE
002	2012-01-01	DAVID SIZEMORE
002	2011-01-01	DAVID SIZEMORE
002	2010-01-01	DAVID A. SIZEMORE JR.
002	2009-01-01	DAVID A. SIZEMORE JR.

Plan Statistics for DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST

Measure Date Value
2013: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 3
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 1
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: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3
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 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 3
Number of participants with account balances 2012-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 7
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 2
Total of all active and inactive participants 2011-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 6
Number of participants with account balances 2011-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 5
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 2
Total of all active and inactive participants 2010-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 7
Number of participants with account balances 2010-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 5
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 2
Total of all active and inactive participants 2009-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 7
Number of participants with account balances 2009-01-01 7
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: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	3
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	1
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: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3
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	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	3
Number of participants with account balances	2012-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	7
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	2
Total of all active and inactive participants	2011-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	6
Number of participants with account balances	2011-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	5
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	2
Total of all active and inactive participants	2010-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	7
Number of participants with account balances	2010-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	5
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	2
Total of all active and inactive participants	2009-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	7
Number of participants with account balances	2009-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2013 : DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$78,583
Expenses. Total of all expenses incurred	2013-12-31	$349,699
Benefits paid (including direct rollovers)	2013-12-31	$343,147
Total plan assets at end of year	2013-12-31	$455,596
Total plan assets at beginning of year	2013-12-31	$726,712
Value of fidelity bond covering the plan	2013-12-31	$225,000
Total contributions received or receivable from participants	2013-12-31	$0
Expenses. Other expenses not covered elsewhere	2013-12-31	$6,552
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$78,583
Net income (gross income less expenses)	2013-12-31	$-271,116
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$455,596
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$726,712
Total contributions received or receivable from employer(s)	2013-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$343,147
2012 : DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$3,473
Total income from all sources	2012-12-31	$57,600
Expenses. Total of all expenses incurred	2012-12-31	$11,146
Benefits paid (including direct rollovers)	2012-12-31	$8,142
Total plan assets at end of year	2012-12-31	$726,712
Total plan assets at beginning of year	2012-12-31	$683,731
Value of fidelity bond covering the plan	2012-12-31	$225,000
Other income received	2012-12-31	$52,527
Net income (gross income less expenses)	2012-12-31	$46,454
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$726,712
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$680,258
Assets. Value of real-estate (other than employer real property)	2012-12-31	$343,147
Total contributions received or receivable from employer(s)	2012-12-31	$5,073
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$3,004
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$3,473
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$-32,127
Expenses. Total of all expenses incurred	2011-12-31	$27,400
Benefits paid (including direct rollovers)	2011-12-31	$24,295
Total plan assets at end of year	2011-12-31	$683,731
Total plan assets at beginning of year	2011-12-31	$739,785
Value of fidelity bond covering the plan	2011-12-31	$225,000
Other income received	2011-12-31	$-32,127
Net income (gross income less expenses)	2011-12-31	$-59,527
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$680,258
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$739,785
Assets. Value of real-estate (other than employer real property)	2011-12-31	$324,950
Total contributions received or receivable from employer(s)	2011-12-31	$4,750
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$3,105
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2010 401k financial data
Total income from all sources	2010-12-31	$41,867
Expenses. Total of all expenses incurred	2010-12-31	$2,319
Total plan assets at end of year	2010-12-31	$739,785
Total plan assets at beginning of year	2010-12-31	$700,237
Value of fidelity bond covering the plan	2010-12-31	$225,000
Expenses. Other expenses not covered elsewhere	2010-12-31	$2,319
Other income received	2010-12-31	$40,867
Net income (gross income less expenses)	2010-12-31	$39,548
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$739,785
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$700,237
Assets. Value of real-estate (other than employer real property)	2010-12-31	$336,387
Total contributions received or receivable from employer(s)	2010-12-31	$1,000

Form 5500 Responses for DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST

2013: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 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	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: DAVID SIZEMORE JR., M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN AND TRUST 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
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:	SIZEMORE, DAVID JR., M.D., A PROFESSIONAL CORPORATION
Employer identification number (EIN):	330049973
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)