PRAIRIE DENTAL ASSOCIATES, P.C. 401(K) PROFIT-SHARING PLAN & TRUST
|
2014
|
205932711
|
2015-05-14
|
PRAIRIE DENTAL ASSOCIATES, P.C.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3096627722
|
Plan sponsor’s
address |
3220 GERIG DRIVE, BLOOMINGTON, IL, 61704
|
Signature of
Role |
Plan administrator |
Date |
2015-05-14 |
Name of individual signing |
KATHRYN M. STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-05-14 |
Name of individual signing |
KATHRYN M. STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAIRIE DENTAL ASSOCIATES, P.C. 401(K) PROFIT-SHARING PLAN & TRUST
|
2013
|
205932711
|
2014-06-21
|
PRAIRIE DENTAL ASSOCIATES, P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3096627722
|
Plan sponsor’s
address |
3220 GERIG DRIVE, BLOOMINGTON, IL, 61704
|
Signature of
Role |
Plan administrator |
Date |
2014-06-21 |
Name of individual signing |
KATHRYN M. STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-06-21 |
Name of individual signing |
KATHRYN M. STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAIRIE DENTAL ASSOCIATES, P.C. 401(K) PROFIT-SHARING PLAN & TRUST
|
2012
|
205932711
|
2013-07-01
|
PRAIRIE DENTAL ASSOCIATES, P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3096627722
|
Plan sponsor’s
address |
3220 GERIG DRIVE, BLOOMINGTON, IL, 61704
|
Signature of
Role |
Plan administrator |
Date |
2013-07-01 |
Name of individual signing |
KATHRYN M. STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-01 |
Name of individual signing |
KATHRYN M. STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAIRIE DENTAL ASSOCIATES, P.C. 401(K) PROFIT-SHARING PLAN & TRUST
|
2011
|
205932711
|
2012-06-11
|
PRAIRIE DENTAL ASSOCIATES, P.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3096627722
|
Plan sponsor’s
address |
3220 GERIG DRIVE, BLOOMINGTON, IL, 61704
|
Plan administrator’s name and address
Administrator’s EIN |
205932711 |
Plan administrator’s name |
PRAIRIE DENTAL ASSOCIATES, P.C. |
Plan administrator’s
address |
3220 GERIG DRIVE, BLOOMINGTON, IL, 61704 |
Administrator’s telephone number |
3096627722 |
Signature of
Role |
Plan administrator |
Date |
2012-06-11 |
Name of individual signing |
RICHARD STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-06-11 |
Name of individual signing |
RICHARD STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAIRIE DENTAL ASSOCIATES, P.C. 401(K) PROFIT-SHARING PLAN & TRUST
|
2010
|
205932711
|
2011-06-08
|
PRAIRIE DENTAL ASSOCIATES, P.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3096627722
|
Plan sponsor’s
address |
3220 GERIG DRIVE, BLOOMINGTON, IL, 61704
|
Plan administrator’s name and address
Administrator’s EIN |
205932711 |
Plan administrator’s name |
PRAIRIE DENTAL ASSOCIATES, P.C. |
Plan administrator’s
address |
3220 GERIG DRIVE, BLOOMINGTON, IL, 61704 |
Administrator’s telephone number |
3096627722 |
Signature of
Role |
Plan administrator |
Date |
2011-06-08 |
Name of individual signing |
RICHARD STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAIRIE DENTAL ASSOCIATES, P.C. 401(K) PROFIT-SHARING PLAN & TRUST
|
2009
|
205932711
|
2010-07-05
|
PRAIRIE DENTAL ASSOCIATES, P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3096627722
|
Plan sponsor’s
address |
3220 GERIG DRIVE, BLOOMINGTON, IL, 61704
|
Plan administrator’s name and address
Administrator’s EIN |
205932711 |
Plan administrator’s name |
PRAIRIE DENTAL ASSOCIATES, P.C. |
Plan administrator’s
address |
3220 GERIG DRIVE, BLOOMINGTON, IL, 61704 |
Administrator’s telephone number |
3096627722 |
Signature of
Role |
Plan administrator |
Date |
2010-07-05 |
Name of individual signing |
RICHARD STEPHEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|