|
CLOCK TOWER DENTAL, P.A. 401(K) PROFIT SHARING PLAN
|
2011
|
412111450
|
2012-09-18
|
CLOCK TOWER DENTAL, P.A.
|
12
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-06
|
| Business code |
621210
|
| Sponsor’s telephone number |
2084559498
|
| Plan sponsor’s
address |
4105 CLOCK TOWER AVE., CALDWELL, ID, 83607
|
Plan administrator’s name and address
| Administrator’s EIN |
412111450 |
| Plan administrator’s name |
CLOCK TOWER DENTAL, P.A. |
| Plan administrator’s
address |
4105 CLOCK TOWER AVE., CALDWELL, ID, 83607 |
| Administrator’s telephone number |
2084559498 |
Signature of
| Role |
Plan administrator |
| Date |
2012-09-18 |
| Name of individual signing |
DARIN MOOSO |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CLOCK TOWER DENTAL, P.A. 401(K) PROFIT SHARING PLAN
|
2010
|
412111450
|
2011-08-03
|
CLOCK TOWER DENTAL, P.A.
|
12
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-06
|
| Business code |
621210
|
| Sponsor’s telephone number |
2084559498
|
| Plan sponsor’s
address |
4105 CLOCK TOWER AVE., CALDWELL, ID, 83607
|
Plan administrator’s name and address
| Administrator’s EIN |
412111450 |
| Plan administrator’s name |
CLOCK TOWER DENTAL, P.A. |
| Plan administrator’s
address |
4105 CLOCK TOWER AVE., CALDWELL, ID, 83607 |
| Administrator’s telephone number |
2084559498 |
Signature of
| Role |
Plan administrator |
| Date |
2011-08-03 |
| Name of individual signing |
AUTHORIZED SIGNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CLOCK TOWER DENTAL, P.A. 401(K) PROFIT SHARING PLAN
|
2009
|
412111450
|
2010-07-27
|
CLOCK TOWER DENTAL, P.A.
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-06
|
| Business code |
621210
|
| Sponsor’s telephone number |
2084559498
|
| Plan sponsor’s
address |
4105 CLOCK TOWER AVE., CALDWELL, ID, 83607
|
Plan administrator’s name and address
| Administrator’s EIN |
412111450 |
| Plan administrator’s name |
CLOCK TOWER DENTAL, P.A. |
| Plan administrator’s
address |
4105 CLOCK TOWER AVE., CALDWELL, ID, 83607 |
| Administrator’s telephone number |
2084559498 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-27 |
| Name of individual signing |
AUTHORIZED SIGNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
