401k Plan data: NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST plan

NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST
Plan identification number	001

NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND 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
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.

401k Sponsoring company profile

NORTHERN LAKE MEDICAL LTD has sponsored the creation of one or more 401k plans.

Company Name: NORTHERN LAKE MEDICAL LTD

Employer identification number (EIN): 363920600

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 MARK TUCCI MD
001 2009-01-01 MARK TUCCI MD

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2011-01-01	MARK TUCCI MD
001	2009-01-01	MARK TUCCI MD

Plan Statistics for NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST

Measure Date Value
2011: NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 41
Total of all active and inactive participants 2011-01-01 0
Total participants 2011-01-01 0
2009: NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 45
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 5
Number of other retired or separated participants entitled to future benefits 2009-01-01 36
Total of all active and inactive participants 2009-01-01 41
Total participants 2009-01-01 41
Number of participants with account balances 2009-01-01 41

Measure	Date	Value
2011: NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	41
Total of all active and inactive participants	2011-01-01	0
Total participants	2011-01-01	0
2009: NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	45
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	5
Number of other retired or separated participants entitled to future benefits	2009-01-01	36
Total of all active and inactive participants	2009-01-01	41
Total participants	2009-01-01	41
Number of participants with account balances	2009-01-01	41

Financial Data on NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2011 : NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Total income from all sources	2011-12-31	$34
Expenses. Total of all expenses incurred	2011-12-31	$166,132
Benefits paid (including direct rollovers)	2011-12-31	$166,012
Total plan assets at end of year	2011-12-31	$0
Total plan assets at beginning of year	2011-12-31	$166,098
Expenses. Other expenses not covered elsewhere	2011-12-31	$120
Other income received	2011-12-31	$34
Net income (gross income less expenses)	2011-12-31	$-166,098
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$166,098
2010 : NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST 2010 401k financial data
Total income from all sources	2010-12-31	$119,114
Expenses. Total of all expenses incurred	2010-12-31	$2,639,686
Benefits paid (including direct rollovers)	2010-12-31	$2,616,424
Total plan assets at end of year	2010-12-31	$166,098
Total plan assets at beginning of year	2010-12-31	$2,686,670
Value of fidelity bond covering the plan	2010-12-31	$20,000
Expenses. Other expenses not covered elsewhere	2010-12-31	$23,262
Other income received	2010-12-31	$119,114
Net income (gross income less expenses)	2010-12-31	$-2,520,572
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$166,098
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,686,670

Form 5500 Responses for NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST

2011: NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	This submission is the final filing	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: NORTHERN LAKE MEDICAL LTD PROFIT SHARING PLAN AND TRUST 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:	NORTHERN LAKE MEDICAL LTD
Employer identification number (EIN):	363920600
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)