|
IMAGE DENTAL LLC 401(K) PROFIT SHARING PLAN & TRUST
|
2020
|
453199860
|
2021-06-03
|
IMAGE DENTAL LLC
|
54
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1990-01-01
|
| Business code |
812990
|
| Sponsor’s telephone number |
3126187663
|
| Plan sponsor’s
address |
3020 S CICERO AVE, CICERO, IL, 608043638
|
Signature of
| Role |
Plan administrator |
| Date |
2021-06-03 |
| Name of individual signing |
NIKITA PATEL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
IMAGE DENTAL LLC 401(K) PROFIT SHARING PLAN & TRUST
|
2019
|
453199860
|
2020-07-22
|
IMAGE DENTAL LLC
|
30
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1990-01-01
|
| Business code |
812990
|
| Sponsor’s telephone number |
3126187663
|
| Plan sponsor’s
address |
3020 S. CICERO AVE., CICERO, IL, 60804
|
Signature of
| Role |
Plan administrator |
| Date |
2020-07-22 |
| Name of individual signing |
RAZAK SINAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
IMAGE DENTAL RETIREMENT PLAN
|
2017
|
453199860
|
2018-09-20
|
IMAGE DENTAL LLC
|
31
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2015-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
7088632000
|
| Plan sponsor’s
address |
3020 CICERO AVENUE, CHICAGO, IL, 608043638
|
Signature of
| Role |
Plan administrator |
| Date |
2018-09-20 |
| Name of individual signing |
MARWAN ALKINJ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2018-09-20 |
| Name of individual signing |
MARWAN ALKINJ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
IMAGE DENTAL RETIREMENT PLAN
|
2016
|
453199860
|
2017-04-26
|
IMAGE DENTAL, LLC
|
20
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2015-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
7088632000
|
| Plan sponsor’s
address |
3020 CICERO AVENUE, CICERO, IL, 60804
|
|
|
IMAGE DENTAL RETIREMENT PLAN
|
2015
|
453199860
|
2016-09-21
|
IMAGE DENTAL, LLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2015-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
7088632000
|
| Plan sponsor’s
address |
3020 CICERO AVENUE, CICERO, IL, 60804
|
|
