|
WHITEWATER ORAL SURGERY PLLC PROFIT SHARING PLAN
|
2022
|
463726284
|
2023-08-29
|
WHITEWATER ORAL SURGERY GROUP PLLC
|
42
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2083427610
|
| Plan sponsor’s
address |
3003 WEST MAIN STREET, SUITE 130, BOISE, ID, 83702
|
Signature of
| Role |
Plan administrator |
| Date |
2023-08-29 |
| Name of individual signing |
KEVIN KEMPERS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
WHITEWATER ORAL SURGERY PLLC PROFIT SHARING PLAN
|
2021
|
463726284
|
2022-06-29
|
WHITEWATER ORAL SURGERY GROUP PLLC
|
37
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2083427610
|
| Plan sponsor’s
address |
3003 W. MAIN STREET, SUITE 130, BOISE, ID, 83702
|
Signature of
| Role |
Plan administrator |
| Date |
2022-06-29 |
| Name of individual signing |
KEVIN KEMPERS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
WHITEWATER ORAL SURGERY GROUP PLLC PROFIT SHARING PLAN
|
2020
|
463726284
|
2021-09-14
|
WHITEWATER ORAL SURGERY GROUP PLLC
|
32
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2083427610
|
| Plan sponsor’s
address |
3003 WEST MAIN STREET, SUITE 130, BOISE, ID, 83702
|
Signature of
| Role |
Plan administrator |
| Date |
2021-09-14 |
| Name of individual signing |
KEVIN KEMPERS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
WHITEWATER ORAL SURGERY GROUP PLLC PROFIT SHARING PLAN
|
2019
|
463726284
|
2020-10-01
|
WHITEWATER ORAL SURGERY GROUP PLLC
|
34
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2083427610
|
| Plan sponsor’s
address |
3003 WEST MAIN STREET, SUITE 130, BOISE, ID, 83702
|
Signature of
| Role |
Plan administrator |
| Date |
2020-10-01 |
| Name of individual signing |
KEVIN KEMPERS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
WHITEWATER ORAL SURGERY GROUP PLLC PROFIT SHARING PLAN
|
2018
|
463726284
|
2019-10-03
|
WHITEWATER ORAL SURGERY GROUP PLLC
|
33
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2083427610
|
| Plan sponsor’s
address |
3003 W. MAIN ST., SUITE 130, BOISE, ID, 83702
|
Signature of
| Role |
Plan administrator |
| Date |
2019-10-03 |
| Name of individual signing |
KEVIN KEMPERS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
WHITEWATER ORAL SURGERY GROUP PLLC PROFIT SHARING PLAN
|
2017
|
463726284
|
2018-05-11
|
WHITEWATER ORAL SURGERY GROUP PLLC
|
28
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2083427610
|
| Plan sponsor’s
address |
3003 W. MAIN ST., SUITE 130, BOISE, ID, 83702
|
Signature of
| Role |
Plan administrator |
| Date |
2018-05-11 |
| Name of individual signing |
KEVIN KEMPERS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
WHITEWATER ORAL SURGERY GROUP PLLC PROFIT SHARING PLAN
|
2016
|
463726284
|
2017-09-18
|
WHITEWATER ORAL SURGERY GROUP PLLC
|
23
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2083427610
|
| Plan sponsor’s mailing address |
3003 W. MAIN ST., SUITE 130, BOISE, ID, 83702
|
| Plan sponsor’s
address |
3003 W. MAIN ST., SUITE 130, BOISE, ID, 83702
|
Number of participants as of the end of the plan year
| Active participants |
16 |
| Other
retired or separated participants entitled to future benefits |
12 |
| Number of
participants
with
account balances as of the end of the plan year |
28 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
| Role |
Plan administrator |
| Date |
2017-09-18 |
| Name of individual signing |
KIM PECK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
