TINLEY DENTAL GROUP, LLC PROFIT SHARING PLAN & TRUST
|
2012
|
223884698
|
2013-07-24
|
TINLEY DENTAL GROUP
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7085324363
|
Plan sponsor’s
address |
16860 OAK PARK AVENUE, SUITE 202, TINLEY PARK, IL, 60477
|
Signature of
Role |
Plan administrator |
Date |
2013-07-24 |
Name of individual signing |
JIM BECKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-24 |
Name of individual signing |
JIM BECKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TINLEY DENTAL GROUP, LLC PROFIT SHARING PLAN & TRUST
|
2011
|
223884698
|
2012-08-26
|
TINLEY DENTAL GROUP
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7085324363
|
Plan sponsor’s
address |
16860 OAK PARK AVENUE, SUITE 202, TINLEY PARK, IL, 60477
|
Plan administrator’s name and address
Administrator’s EIN |
223884698 |
Plan administrator’s name |
TINLEY DENTAL GROUP |
Plan administrator’s
address |
16860 OAK PARK AVENUE, SUITE 202, TINLEY PARK, IL, 60477 |
Administrator’s telephone number |
7085324363 |
Signature of
Role |
Plan administrator |
Date |
2012-08-26 |
Name of individual signing |
JIM BECKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-08-26 |
Name of individual signing |
JIM BECKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TINLEY DENTAL GROUP LLC PROFIT SHARING PLAN TRUST
|
2010
|
223884698
|
2011-08-14
|
TINLEY DENTAL GROUP
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7085324363
|
Plan sponsor’s
address |
16860 OAK PARK AVENUE, SUITE 202, TINLEY PARK, IL, 60477
|
Plan administrator’s name and address
Administrator’s EIN |
223884698 |
Plan administrator’s name |
TINLEY DENTAL GROUP |
Plan administrator’s
address |
16860 OAK PARK AVENUE, SUITE 202, TINLEY PARK, IL, 60477 |
Administrator’s telephone number |
7085324363 |
Signature of
Role |
Plan administrator |
Date |
2011-08-14 |
Name of individual signing |
JIM BECKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-08-14 |
Name of individual signing |
JIM BECKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TINLEY DENTAL GROUP LLC PROFIT SHARING PLAN TRUST
|
2009
|
223884698
|
2010-10-01
|
TINLEY DENTAL GROUP
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7085324363
|
Plan sponsor’s
address |
16860 OAK PARK AVENUE, SUITE 202, TINLEY PARK, IL, 60477
|
Plan administrator’s name and address
Administrator’s EIN |
223884698 |
Plan administrator’s name |
TINLEY DENTAL GROUP |
Plan administrator’s
address |
16860 OAK PARK AVENUE, SUITE 202, TINLEY PARK, IL, 60477 |
Administrator’s telephone number |
7085324363 |
Signature of
Role |
Plan administrator |
Date |
2010-09-30 |
Name of individual signing |
JIM BECKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-01 |
Name of individual signing |
JIM BECKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|