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  5. EYE CLINIC OF IDAHO FALLS, P.A.

EYE CLINIC OF IDAHO FALLS, P.A.

Company Details

Name: EYE CLINIC OF IDAHO FALLS, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 19 Oct 1973 (51 years ago)
Financial Date End: 31 Oct 2016
Date dissolved: 24 Jan 2017
Entity Number: 156787
Place of Formation: IDAHO
File Number: 0000156787
ZIP code: 83404
County: Bonneville County
Mailing Address: 2531 PARKVIEW LN IDAHO FALLS, ID 83404

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EYE CLINIC OF IDAHO FALLS, PA 401(K) 2016 820307581 2017-08-28 EYE CLINIC OF IDAHO FALLS, P.A. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2085211520
Plan sponsor’s address 2531 PARKVIEW LANE, IDAHO FALLS, ID, 83404

Signature of
Role Plan administrator
Date 2017-08-28
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
EYE CLINIC OF IDAHO FALLS, PA 401(K) 2015 820307581 2016-04-21 EYE CLINIC OF IDAHO FALLS, P.A. 6
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2085211520
Plan sponsor’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410

Signature of
Role Plan administrator
Date 2016-04-21
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
EYE CLINIC OF IDAHO FALLS, PA 401(K) 2014 820307581 2015-07-10 EYE CLINIC OF IDAHO FALLS, P.A. 5
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2085293937
Plan sponsor’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410

Signature of
Role Plan administrator
Date 2015-07-10
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-10
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
EYE CLINIC OF IDAHO FALLS, PA 401(K) 2013 820307581 2014-07-23 EYE CLINIC OF IDAHO FALLS, P.A. 5
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2085293937
Plan sponsor’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410

Signature of
Role Plan administrator
Date 2014-07-23
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-23
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
EYE CLINIC OF IDAHO FALLS, PA 401(K) 2012 820307581 2013-08-20 EYE CLINIC OF IDAHO FALLS, P.A. 6
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2085293937
Plan sponsor’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410

Signature of
Role Plan administrator
Date 2013-08-20
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-20
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
EYE CLINIC OF IDAHO FALLS, P.A. 401(K) PROFIT SHARING PLAN 2011 820307581 2012-10-09 EYE CLINIC OF IDAHO FALLS, P.A. 6
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2085293937
Plan sponsor’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410

Plan administrator’s name and address
Administrator’s EIN 820307581
Plan administrator’s name EYE CLINIC OF IDAHO FALLS, P.A.
Plan administrator’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410
Administrator’s telephone number 2085293937

Signature of
Role Plan administrator
Date 2012-10-09
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-09
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
EYE CLINIC OF IDAHO FALLS, P.A. 401(K) PROFIT SHARING PLAN 2010 820307581 2011-07-25 EYE CLINIC OF IDAHO FALLS, P.A. 5
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2085293937
Plan sponsor’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410

Plan administrator’s name and address
Administrator’s EIN 820307581
Plan administrator’s name EYE CLINIC OF IDAHO FALLS, P.A.
Plan administrator’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410
Administrator’s telephone number 2085293937

Signature of
Role Plan administrator
Date 2011-07-25
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-25
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
EYE CLINIC OF IDAHO FALLS, P.A. 401(K) PROFIT SHARING PLAN 2009 820307581 2010-07-21 EYE CLINIC OF IDAHO FALLS, P.A. 6
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2085293937
Plan sponsor’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410

Plan administrator’s name and address
Administrator’s EIN 820307581
Plan administrator’s name EYE CLINIC OF IDAHO FALLS, P.A.
Plan administrator’s address P.O. BOX 2410, IDAHO FALLS, ID, 834032410
Administrator’s telephone number 2085293937

Signature of
Role Plan administrator
Date 2010-07-21
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-21
Name of individual signing DAVID R. ANDERSON
Valid signature Filed with authorized/valid electronic signature

Filing

Filing Name Filing Number Filing date
Annual Report 0001532912 2016-01-07
Annual Report 0001532910 2014-09-17
Annual Report 0001532908 2013-08-12
Annual Report 0001532906 2012-08-15
Annual Report 0001532898 2011-08-09
Annual Report 0001532896 2010-08-10
Annual Report 0001532894 2009-08-17
Annual Report 0001532903 2008-08-25
Annual Report 0001532901 2007-08-13
Annual Report 0001532882 2006-09-07

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State

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