|
GEORGE DENTAL CLINIC, P.A. PROFIT SHARING PLAN
|
2011
|
820389568
|
2013-10-03
|
GEORGE DENTAL CLINIC, P.A.
|
22
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1997-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087458704
|
| Plan sponsor’s
address |
527 RIGBY LAKE DRIVE, SUITE B, RIGBY, ID, 83442
|
Plan administrator’s name and address
| Administrator’s EIN |
820389568 |
| Plan administrator’s name |
GEORGE DENTAL CLINIC, P.A. |
| Plan administrator’s
address |
527 RIGBY LAKE DRIVE, SUITE B, RIGBY, ID, 83442 |
| Administrator’s telephone number |
2087458704 |
Signature of
| Role |
Plan administrator |
| Date |
2013-10-03 |
| Name of individual signing |
RICHARD H. GEORGE, DDS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GEORGE DENTAL CLINIC, P.A. PROFIT SHARING PLAN
|
2011
|
820389568
|
2013-10-04
|
GEORGE DENTAL CLINIC, P.A.
|
22
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1997-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087458704
|
| Plan sponsor’s
address |
527 RIGBY LAKE DRIVE, SUITE B, RIGBY, ID, 83442
|
Plan administrator’s name and address
| Administrator’s EIN |
820389568 |
| Plan administrator’s name |
GEORGE DENTAL CLINIC, P.A. |
| Plan administrator’s
address |
527 RIGBY LAKE DRIVE, SUITE B, RIGBY, ID, 83442 |
| Administrator’s telephone number |
2087458704 |
Signature of
| Role |
Plan administrator |
| Date |
2013-10-03 |
| Name of individual signing |
RICHARD H. GEORGE, DDS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GEORGE DENTAL CLINIC, P.A. PROFIT SHARING PLAN
|
2011
|
820389568
|
2012-10-04
|
GEORGE DENTAL CLINIC, P.A.
|
22
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1997-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087458704
|
| Plan sponsor’s
address |
527 RIGBY LAKE DRIVE, SUITE B, RIGBY, ID, 83442
|
Plan administrator’s name and address
| Administrator’s EIN |
820389568 |
| Plan administrator’s name |
GEORGE DENTAL CLINIC, P.A. |
| Plan administrator’s
address |
527 RIGBY LAKE DRIVE, SUITE B, RIGBY, ID, 83442 |
| Administrator’s telephone number |
2087458704 |
Signature of
| Role |
Plan administrator |
| Date |
2012-10-04 |
| Name of individual signing |
RICHARD H. GEORGE, DDS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-10-04 |
| Name of individual signing |
RICHARD H. GEORGE, DDS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GEORGE DENTAL CLINIC, P.A. PROFIT SHARING PLAN
|
2010
|
820389568
|
2011-10-07
|
GEORGE DENTAL CLINIC, P.A.
|
23
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1997-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087458704
|
| Plan sponsor’s
address |
527 RIGBY LAKE DRIVE, SUITE B, RIGBY, ID, 83442
|
Plan administrator’s name and address
| Administrator’s EIN |
820389568 |
| Plan administrator’s name |
GEORGE DENTAL CLINIC, P.A. |
| Plan administrator’s
address |
527 RIGBY LAKE DRIVE, SUITE B, RIGBY, ID, 83442 |
| Administrator’s telephone number |
2087458704 |
Signature of
| Role |
Plan administrator |
| Date |
2011-10-06 |
| Name of individual signing |
RICHARD H. GEORGE, DDS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-10-06 |
| Name of individual signing |
RICHARD H. GEORGE, DDS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
