DENTAL ARTS LABORATORY, INC FLEXIBLE SPENDING PLAN
|
2021
|
370908905
|
2023-07-14
|
DENTAL ARTS LABORATORIES, INC
|
307
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748191
|
Plan sponsor’s mailing address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Plan sponsor’s
address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-07-14 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-07-14 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL ARTS LABORATORY, INC FLEXIBLE SPENDING PLAN
|
2020
|
370908905
|
2022-07-11
|
DENTAL ARTS LABORATORIES, INC
|
275
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748191
|
Plan sponsor’s mailing address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Plan sponsor’s
address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Number of participants as of the end of the plan year
Active participants |
268 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2022-07-11 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL ARTS LABORATORY, INC FLEXIBLE SPENDING PLAN
|
2019
|
370908905
|
2021-06-24
|
DENTAL ARTS LABORATORIES INC
|
230
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748191
|
Plan sponsor’s mailing address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Plan sponsor’s
address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Number of participants as of the end of the plan year
Active participants |
221 |
Retired or separated participants receiving
benefits |
3 |
Signature of
Role |
Plan administrator |
Date |
2021-06-24 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL ARTS LABORATORY, INC FLEXIBLE SPENDING PLAN
|
2018
|
370908905
|
2020-06-19
|
DENTAL ARTS LABORATORIES, INC.
|
300
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748191
|
Plan sponsor’s mailing address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Plan sponsor’s
address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Number of participants as of the end of the plan year
Active participants |
284 |
Retired or separated participants receiving
benefits |
4 |
Signature of
Role |
Plan administrator |
Date |
2020-06-19 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL ARTS LABORATORY, INC FLEXIBLE SPENDING PLAN
|
2017
|
370908905
|
2019-07-08
|
DENTAL ARTS LABORATORIES, INC
|
307
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748191
|
Plan sponsor’s mailing address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Plan sponsor’s
address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Number of participants as of the end of the plan year
Active participants |
302 |
Retired or separated participants receiving
benefits |
2 |
Signature of
Role |
Plan administrator |
Date |
2019-07-08 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL ARTS LABORATORY, INC FLEXIBLE SPENDING PLAN
|
2016
|
370908905
|
2018-06-19
|
DENTAL ARTS LABORATORIES INC
|
307
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748191
|
Plan sponsor’s mailing address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Plan sponsor’s
address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-06-19 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-19 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL ARTS LABORATORY, INC. FLEXIBLE SPENDING PLAN
|
2015
|
370908905
|
2017-06-23
|
DENTAL ARTS LABORATORIES INC
|
276
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748199
|
Plan sponsor’s mailing address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Plan sponsor’s
address |
216 NE PERRY AVE, PEORIA, IL, 616033626
|
Number of participants as of the end of the plan year
Active participants |
292 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-06-23 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-23 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL ARTS LABORATORY, INC. FLEXIBLE SPENDING PLAN
|
2014
|
370908905
|
2016-07-08
|
DENTAL ARTS LABORATORIES, INC
|
274
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748191
|
Plan sponsor’s mailing address |
216 N E PERRY AVE., PEORIA, IL, 61603
|
Plan sponsor’s
address |
216 N E PERRY AVE., PEORIA, IL, 61603
|
Number of participants as of the end of the plan year
Active participants |
278 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-07-08 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-08 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL ARTS LABORATORY, INC. FLEXIBLE SPENDING PLAN
|
2013
|
370908905
|
2015-06-22
|
DENTAL ARTS LABORATORIES, INC
|
259
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748191
|
Plan sponsor’s mailing address |
216 N E PERRY AVE., PEORIA, IL, 61603
|
Plan sponsor’s
address |
216 N E PERRY AVE., PEORIA, IL, 61603
|
Number of participants as of the end of the plan year
Active participants |
259 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-06-22 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-06-22 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL ARTS LABORATORY, INC. FLEXIBLE SPENDING PLAN
|
2012
|
370908905
|
2014-07-02
|
DENTAL ARTS LABORATORY INC
|
256
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2005-07-01
|
Business code |
621510
|
Sponsor’s telephone number |
3096748191
|
Plan sponsor’s mailing address |
216 N E PERRY AVE., PEORIA, IL, 61603
|
Plan sponsor’s
address |
216 N E PERRY AVE., PEORIA, IL, 61603
|
Plan administrator’s name and address
Administrator’s EIN |
370908905 |
Plan administrator’s name |
DENTAL ARTS LABORATORY INC |
Administrator’s telephone number |
3096748191 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-07-02 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-02 |
Name of individual signing |
ROSANNE NAU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|