|
LARSEN DENTAL 401(K) PLAN
|
2014
|
263306896
|
2015-10-13
|
BRYCE LARSEN DMD PLLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1998-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2082337007
|
| Plan sponsor’s
address |
950 HOSPITAL WAY, SUITE B, POCATELLO, ID, 83201
|
Signature of
| Role |
Plan administrator |
| Date |
2015-10-13 |
| Name of individual signing |
BRYCE LARSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LARSEN DENTAL 401(K) PLAN
|
2014
|
263306896
|
2015-09-02
|
BRYCE LARSEN DMD PLLC
|
10
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1998-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2082337007
|
| Plan sponsor’s
address |
950 HOSPITAL WAY, SUITE B, POCATELLO, ID, 83201
|
Signature of
| Role |
Plan administrator |
| Date |
2015-09-02 |
| Name of individual signing |
BRYCE LARSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LARSEN DENTAL LLC 401(K) PLAN
|
2014
|
263306896
|
2015-10-12
|
BRYCE LARSEN DMD PLLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1998-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2082337007
|
| Plan sponsor’s
address |
950 HOSPITAL WAY, SUITE B, POCATELLO, ID, 83201
|
Signature of
| Role |
Plan administrator |
| Date |
2015-10-12 |
| Name of individual signing |
BRYCE LARSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LARSEN DENTAL LLC 401(K) PLAN
|
2013
|
263306896
|
2014-10-08
|
BRYCE LARSEN DMD PLLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1998-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2082337007
|
| Plan sponsor’s
address |
950 HOSPITAL WAY, SUITE B, POCATELLO, ID, 83201
|
Signature of
| Role |
Plan administrator |
| Date |
2014-10-08 |
| Name of individual signing |
BRYCE LARSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
