|
MAPLE GROVE DENTISTRY 401(K) PLAN
|
2023
|
474641890
|
2024-10-10
|
RUSSELL JENSEN DMD LLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2088532221
|
| Plan sponsor’s
address |
3270 N. MAPLE GROVE RD, BOISE, ID, 83704
|
Signature of
| Role |
Plan administrator |
| Date |
2024-10-10 |
| Name of individual signing |
RUSSELL JENSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MAPLE GROVE DENTISTRY 401(K) PLAN
|
2022
|
474641890
|
2023-07-11
|
RUSSELL JENSEN DMD LLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2088532221
|
| Plan sponsor’s
address |
3270 N. MAPLE GROVE RD, BOISE, ID, 83704
|
Signature of
| Role |
Plan administrator |
| Date |
2023-07-11 |
| Name of individual signing |
RUSSELL JENSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MAPLE GROVE DENTISTRY 401(K) PLAN
|
2021
|
474641890
|
2022-10-12
|
RUSSELL JENSEN DMD LLC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2088532221
|
| Plan sponsor’s
address |
3270 N. MAPLE GROVE RD, BOISE, ID, 83704
|
Signature of
| Role |
Plan administrator |
| Date |
2022-10-12 |
| Name of individual signing |
RUSSELL JENSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
