401k Plan data: NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN plan

NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN 401k Plan overview

Plan Name	NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN
Plan identification number	001

NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) 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.
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

NANCY A. MONTGOMERY, DDS, MS, INC. has sponsored the creation of one or more 401k plans.

Company Name: NANCY A. MONTGOMERY, DDS, MS, INC.

Employer identification number (EIN): 753140609

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 ROB MARTIN
001 2011-01-01 ROB MARTIN
001 2009-01-01 NANCY MONTGOMERY

Plan id#	Filing Submission Date	Name of Administrator
001	2012-01-01	ROB MARTIN
001	2011-01-01	ROB MARTIN
001	2009-01-01	NANCY MONTGOMERY

Plan Statistics for NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN

401k plan membership statisitcs for NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN

Measure Date Value
2012: NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) 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 6
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 8
Total participants 2011-01-01 8
Number of participants with account balances 2011-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
Number of other retired or separated participants entitled to future benefits 2009-01-01 1
Total of all active and inactive participants 2009-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 5
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
2012: NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) 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	6
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	8
Total participants	2011-01-01	8
Number of participants with account balances	2011-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
Number of other retired or separated participants entitled to future benefits	2009-01-01	1
Total of all active and inactive participants	2009-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	5
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 NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN

Measure	Date	Value
2012 : NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-11-19	$32,620
Expenses. Total of all expenses incurred	2012-11-19	$295,003
Benefits paid (including direct rollovers)	2012-11-19	$294,478
Total plan assets at end of year	2012-11-19	$0
Total plan assets at beginning of year	2012-11-19	$262,383
Value of fidelity bond covering the plan	2012-11-19	$132,000
Total contributions received or receivable from participants	2012-11-19	$12,851
Assets. Value of loans (other than to participants)	2012-11-19	$0
Other income received	2012-11-19	$14,770
Net income (gross income less expenses)	2012-11-19	$-262,383
Net plan assets at end of year (total assets less liabilities)	2012-11-19	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-11-19	$262,383
Assets. Value of assets in partnership/joint-venture interests	2012-11-19	$0
Total contributions received or receivable from employer(s)	2012-11-19	$4,999
Expenses. Administrative service providers (salaries,fees and commissions)	2012-11-19	$525
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-11-19	$0
2011 : NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$28,674
Expenses. Total of all expenses incurred	2011-12-31	$4,948
Benefits paid (including direct rollovers)	2011-12-31	$4,717
Total plan assets at end of year	2011-12-31	$262,383
Total plan assets at beginning of year	2011-12-31	$238,657
Value of fidelity bond covering the plan	2011-12-31	$132,000
Total contributions received or receivable from participants	2011-12-31	$19,251
Assets. Value of loans (other than to participants)	2011-12-31	$100,000
Other income received	2011-12-31	$3,068
Net income (gross income less expenses)	2011-12-31	$23,726
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$262,383
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$238,657
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$74,250
Total contributions received or receivable from employer(s)	2011-12-31	$6,355
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$231
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$31,915
Expenses. Total of all expenses incurred	2010-12-31	$100
Total plan assets at end of year	2010-12-31	$238,657
Total plan assets at beginning of year	2010-12-31	$206,842
Value of fidelity bond covering the plan	2010-12-31	$132,000
Total contributions received or receivable from participants	2010-12-31	$17,920
Assets. Value of loans (other than to participants)	2010-12-31	$100,000
Other income received	2010-12-31	$10,768
Net income (gross income less expenses)	2010-12-31	$31,815
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$238,657
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$206,842
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$49,500
Total contributions received or receivable from employer(s)	2010-12-31	$3,227
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$100

Form 5500 Responses for NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) PLAN

2012: NANCY A. MONTGOMERY, DDS, MS, INC. 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	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: NANCY A. MONTGOMERY, DDS, MS, INC. 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 – 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
2009: NANCY A. MONTGOMERY, DDS, MS, INC. 401(K) 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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	NANCY A. MONTGOMERY, DDS, MS, INC.
Employer identification number (EIN):	753140609
NAIC Classification:	621210
NAIC Description:	Offices of Dentists