JAMES W. MELLERT, DDS, INC. WELFARE BENEFIT TRUST

[ EIN: 33-0056789 | Plan No. 501 ]

JAMES W. MELLERT, DDS, INC. WELFARE BENEFIT TRUST, sponsored by JAMES W. MELLERT, DDS, INC., appears in Form 5500 filings as a Health & Welfare plan. The plan reported 0 participants and total assets of $0 during the 2012 reporting period.

Health & Welfare plans are subject to ERISA disclosure requirements and annual reporting obligations.

---

Plan Sponsor: JAMES W. MELLERT, DDS, INC.

Location: 21350 HAWTHORNE BOULEVARD, SUITE 17, TORRANCE, CA 90503

EIN: 330056789

Plan Number: 501

Plan Year: 2012

Plan Size: Small Plan

Plan Entity Type: Health & Welfare

Plan Type: Health & Welfare

Participants: 0

Total Assets: $0

---