401k Plan data: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN plan

JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 401k Plan overview

Plan Name	JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN
Plan identification number	004

JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 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
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

JAMES B. MACOMSON, D.D.S., M.S.O., P.A. has sponsored the creation of one or more 401k plans.

Company Name: JAMES B. MACOMSON, D.D.S., M.S.O., P.A.

Employer identification number (EIN): 561189777

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2022-01-01 MATT HALE 2023-08-15
004 2021-01-01 MATT HALE 2022-05-18
004 2021-01-01 MATT HALE 2022-09-30
004 2020-01-01 JESSICA E. SIETSEMA 2021-07-06
004 2019-01-01 MATT HALE 2020-11-09
004 2017-01-01
004 2016-01-01
004 2015-01-01 JAMES MACOMSON JAMES MACOMSON 2016-08-31
004 2014-01-01 JAMES MACOMSON JAMES MACOMSON 2015-10-09
004 2013-01-01 JAMES MACOMSON JAMES MACOMSON 2014-10-14
004 2012-01-01 JAMES MACOMSON JAMES MACOMSON 2013-10-02
004 2011-01-01 JAMES MACOMSON
004 2010-01-01 JAMES MACOMSON
004 2009-01-01 JAMES MACOMSON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
004	2022-01-01	MATT HALE	2023-08-15
004	2021-01-01	MATT HALE	2022-05-18
004	2021-01-01	MATT HALE	2022-09-30
004	2020-01-01	JESSICA E. SIETSEMA	2021-07-06
004	2019-01-01	MATT HALE	2020-11-09
004	2017-01-01
004	2016-01-01
004	2015-01-01	JAMES MACOMSON		JAMES MACOMSON	2016-08-31
004	2014-01-01	JAMES MACOMSON		JAMES MACOMSON	2015-10-09
004	2013-01-01	JAMES MACOMSON		JAMES MACOMSON	2014-10-14
004	2012-01-01	JAMES MACOMSON		JAMES MACOMSON	2013-10-02
004	2011-01-01	JAMES MACOMSON
004	2010-01-01	JAMES MACOMSON
004	2009-01-01	JAMES MACOMSON

Plan Statistics for JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN

401k plan membership statisitcs for JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN

Measure Date Value
2022: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 9
Number of retired or separated participants receiving benefits 2022-01-01 2
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 11
Number of participants with account balances 2022-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 10
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 2
Total of all active and inactive participants 2021-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 13
Number of participants with account balances 2021-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 10
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 2
Total of all active and inactive participants 2020-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 13
Number of participants with account balances 2020-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 10
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 1
Total of all active and inactive participants 2019-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 12
Number of participants with account balances 2019-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2017: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 9
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 9
Number of participants with account balances 2017-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 10
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 1
Total of all active and inactive participants 2016-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 11
Number of participants with account balances 2016-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 1
2015: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 10
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 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 10
Number of participants with account balances 2015-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 10
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 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 10
Number of participants with account balances 2014-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 10
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 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 11
Number of participants with account balances 2013-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 10
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 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 10
Number of participants with account balances 2012-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 9
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 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 11
Number of participants with account balances 2011-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 11
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 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 11
Number of participants with account balances 2010-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 11
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 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 11
Number of participants with account balances 2009-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	9
Number of retired or separated participants receiving benefits	2022-01-01	2
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	11
Number of participants with account balances	2022-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	10
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	2
Total of all active and inactive participants	2021-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	13
Number of participants with account balances	2021-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	10
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	2
Total of all active and inactive participants	2020-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	13
Number of participants with account balances	2020-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	10
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	1
Total of all active and inactive participants	2019-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	12
Number of participants with account balances	2019-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2017: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	9
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	9
Number of participants with account balances	2017-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	10
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	1
Total of all active and inactive participants	2016-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	11
Number of participants with account balances	2016-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1
2015: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	10
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	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	10
Number of participants with account balances	2015-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	10
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	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	10
Number of participants with account balances	2014-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	10
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	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	11
Number of participants with account balances	2013-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	10
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	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	10
Number of participants with account balances	2012-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	9
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	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	11
Number of participants with account balances	2011-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	11
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	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	11
Number of participants with account balances	2010-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	11
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	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	11
Number of participants with account balances	2009-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN

Measure	Date	Value
2022 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2022 401k financial data
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-569,703
Expenses. Total of all expenses incurred	2022-12-31	$128,103
Benefits paid (including direct rollovers)	2022-12-31	$107,000
Total plan assets at end of year	2022-12-31	$2,785,862
Total plan assets at beginning of year	2022-12-31	$3,483,668
Total contributions received or receivable from participants	2022-12-31	$8,061
Expenses. Other expenses not covered elsewhere	2022-12-31	$21,103
Contributions received from other sources (not participants or employers)	2022-12-31	$0
Other income received	2022-12-31	$-586,633
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-697,806
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$2,785,862
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$3,483,668
Assets. Value of assets in partnership/joint-venture interests	2022-12-31	$56,644
Total contributions received or receivable from employer(s)	2022-12-31	$8,869
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$0
2021 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$77,820
Expenses. Total of all expenses incurred	2021-12-31	$81,991
Benefits paid (including direct rollovers)	2021-12-31	$59,720
Total plan assets at end of year	2021-12-31	$3,294,057
Total plan assets at beginning of year	2021-12-31	$3,298,228
Total contributions received or receivable from participants	2021-12-31	$7,803
Expenses. Other expenses not covered elsewhere	2021-12-31	$22,271
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$56,814
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$-4,171
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$3,294,057
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$3,298,228
Assets. Value of participant loans	2021-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2021-12-31	$55,183
Total contributions received or receivable from employer(s)	2021-12-31	$13,203
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$363,394
Expenses. Total of all expenses incurred	2020-12-31	$166,683
Benefits paid (including direct rollovers)	2020-12-31	$166,683
Total plan assets at end of year	2020-12-31	$3,298,228
Total plan assets at beginning of year	2020-12-31	$3,101,517
Total contributions received or receivable from participants	2020-12-31	$7,273
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$342,777
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$196,711
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$3,298,228
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$3,101,517
Assets. Value of participant loans	2020-12-31	$544
Assets. Value of assets in partnership/joint-venture interests	2020-12-31	$53,174
Total contributions received or receivable from employer(s)	2020-12-31	$13,344
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$462,986
Expenses. Total of all expenses incurred	2019-12-31	$133,881
Benefits paid (including direct rollovers)	2019-12-31	$133,881
Total plan assets at end of year	2019-12-31	$3,101,517
Total plan assets at beginning of year	2019-12-31	$2,772,412
Total contributions received or receivable from participants	2019-12-31	$7,322
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$443,949
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$329,105
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$3,101,517
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$2,772,412
Assets. Value of participant loans	2019-12-31	$1,448
Assets. Value of assets in partnership/joint-venture interests	2019-12-31	$47,869
Total contributions received or receivable from employer(s)	2019-12-31	$11,715
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2017 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2017 401k financial data
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$758,449
Expenses. Total of all expenses incurred	2017-12-31	$21,481
Benefits paid (including direct rollovers)	2017-12-31	$4,625
Total plan assets at end of year	2017-12-31	$5,167,925
Total plan assets at beginning of year	2017-12-31	$4,430,957
Total contributions received or receivable from participants	2017-12-31	$11,896
Expenses. Other expenses not covered elsewhere	2017-12-31	$16,856
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$700,463
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$736,968
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$5,167,925
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$4,430,957
Assets. Value of participant loans	2017-12-31	$3,159
Total contributions received or receivable from employer(s)	2017-12-31	$46,090
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$518,758
Expenses. Total of all expenses incurred	2016-12-31	$164,496
Benefits paid (including direct rollovers)	2016-12-31	$146,090
Total plan assets at end of year	2016-12-31	$4,430,957
Total plan assets at beginning of year	2016-12-31	$4,076,695
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$34,442
Other income received	2016-12-31	$426,679
Net income (gross income less expenses)	2016-12-31	$354,262
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$4,430,957
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$4,076,695
Assets. Value of participant loans	2016-12-31	$143
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$31,587
Total contributions received or receivable from employer(s)	2016-12-31	$57,637
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$18,406
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$32,836
Expenses. Total of all expenses incurred	2015-12-31	$512,354
Benefits paid (including direct rollovers)	2015-12-31	$494,609
Total plan assets at end of year	2015-12-31	$4,076,695
Total plan assets at beginning of year	2015-12-31	$4,556,213
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$54,636
Other income received	2015-12-31	$-80,115
Net income (gross income less expenses)	2015-12-31	$-479,518
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$4,076,695
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$4,556,213
Assets. Value of participant loans	2015-12-31	$978
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$79,328
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	2015-12-31	$2,363
Total contributions received or receivable from employer(s)	2015-12-31	$58,315
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$17,745
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$49,205
Total income from all sources	2014-12-31	$236,318
Expenses. Total of all expenses incurred	2014-12-31	$268,923
Benefits paid (including direct rollovers)	2014-12-31	$252,299
Total plan assets at end of year	2014-12-31	$4,556,213
Total plan assets at beginning of year	2014-12-31	$4,638,023
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$12,907
Other income received	2014-12-31	$223,136
Net income (gross income less expenses)	2014-12-31	$-32,605
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$4,556,213
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$4,588,818
Assets. Value of participant loans	2014-12-31	$1,833
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$89,119
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	2014-12-31	$23,762
Total contributions received or receivable from employer(s)	2014-12-31	$275
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$16,624
2013 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$49,205
Total income from all sources	2013-12-31	$745,540
Expenses. Total of all expenses incurred	2013-12-31	$149,572
Benefits paid (including direct rollovers)	2013-12-31	$134,129
Total plan assets at end of year	2013-12-31	$4,638,023
Total plan assets at beginning of year	2013-12-31	$3,992,850
Value of fidelity bond covering the plan	2013-12-31	$320,000
Total contributions received or receivable from participants	2013-12-31	$35,144
Other income received	2013-12-31	$654,146
Net income (gross income less expenses)	2013-12-31	$595,968
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$4,588,818
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,992,850
Assets. Value of participant loans	2013-12-31	$2,460
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$19,683
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	2013-12-31	$21,398
Total contributions received or receivable from employer(s)	2013-12-31	$56,250
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$15,443
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$408,921
Expenses. Total of all expenses incurred	2012-12-31	$48,185
Benefits paid (including direct rollovers)	2012-12-31	$34,382
Total plan assets at end of year	2012-12-31	$3,992,850
Total plan assets at beginning of year	2012-12-31	$3,632,114
Value of fidelity bond covering the plan	2012-12-31	$320,000
Total contributions received or receivable from participants	2012-12-31	$36,171
Other income received	2012-12-31	$316,292
Net income (gross income less expenses)	2012-12-31	$360,736
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,992,850
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$3,632,114
Assets. Value of participant loans	2012-12-31	$3,176
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$4,293
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	$9,564
Total contributions received or receivable from employer(s)	2012-12-31	$56,458
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$13,803
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$-48,428
Expenses. Total of all expenses incurred	2011-12-31	$11,134
Total plan assets at end of year	2011-12-31	$3,632,114
Total plan assets at beginning of year	2011-12-31	$3,691,676
Value of fidelity bond covering the plan	2011-12-31	$320,000
Total contributions received or receivable from participants	2011-12-31	$34,681
Other income received	2011-12-31	$-138,659
Net income (gross income less expenses)	2011-12-31	$-59,562
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$3,632,114
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$3,691,676
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$4,585
Total contributions received or receivable from employer(s)	2011-12-31	$55,550
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$11,134
2010 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at beginning of year	2010-12-31	$26,907
Total income from all sources	2010-12-31	$387,217
Expenses. Total of all expenses incurred	2010-12-31	$2,068,407
Benefits paid (including direct rollovers)	2010-12-31	$2,053,082
Total plan assets at end of year	2010-12-31	$3,691,676
Total plan assets at beginning of year	2010-12-31	$5,399,773
Value of fidelity bond covering the plan	2010-12-31	$320,000
Total contributions received or receivable from participants	2010-12-31	$33,901
Other income received	2010-12-31	$295,712
Net income (gross income less expenses)	2010-12-31	$-1,681,190
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$3,691,676
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$5,372,866
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$0
Total contributions received or receivable from employer(s)	2010-12-31	$57,604
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$15,325
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN

2022: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2017: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING 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	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: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING 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: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING 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
2010: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: JAMES B. MACOMSON, D.D.S., M.S.O., P.A. PROFIT SHARING PLAN 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

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

PFT8014

Policy instance

Insurance contract or identification number	PFT8014
Number of Individuals Covered	3
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

PFT8014

Policy instance

Insurance contract or identification number	PFT8014
Number of Individuals Covered	3
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

PFT8014

Policy instance

Insurance contract or identification number	PFT8014
Number of Individuals Covered	3
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $19,460
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,460
Insurance broker organization code?	3
Insurance broker name	LONNIE A. WAGGONER

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Company Name:	JAMES B. MACOMSON, D.D.S., M.S.O., P.A.
Employer identification number (EIN):	561189777
NAIC Classification:	621210
NAIC Description:	Offices of Dentists