|
J. BRENT BERREY, D.M.D., P.A. RETIREMENT PLAN
|
2011
|
202442379
|
2012-08-27
|
J. BRENT BERREY, D.M.D., P.A.
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-04-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2082335362
|
| Plan sponsor’s
address |
1717 LANCE DR., POCATELLO, ID, 832044917
|
Plan administrator’s name and address
| Administrator’s EIN |
202442379 |
| Plan administrator’s name |
J. BRENT BERREY, D.M.D., P.A. |
| Plan administrator’s
address |
1717 LANCE DR., POCATELLO, ID, 832044917 |
| Administrator’s telephone number |
2082335362 |
Signature of
| Role |
Plan administrator |
| Date |
2012-08-27 |
| Name of individual signing |
ELEANOR BERREY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
J. BRENT BERREY, D.M.D., P.A. RETIREMENT PLAN
|
2011
|
202442379
|
2012-07-09
|
J. BRENT BERREY, D.M.D., P.A.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-04-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2082335362
|
| Plan sponsor’s
address |
1717 LANCE DR., POCATELLO, ID, 832044917
|
Plan administrator’s name and address
| Administrator’s EIN |
202442379 |
| Plan administrator’s name |
J. BRENT BERREY, D.M.D., P.A. |
| Plan administrator’s
address |
1717 LANCE DR., POCATELLO, ID, 832044917 |
| Administrator’s telephone number |
2082335362 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-09 |
| Name of individual signing |
ELEANOR BERREY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
J. BRENT BERREY, D.M.D., P.A. RETIREMENT PLAN
|
2010
|
202442379
|
2011-02-01
|
J. BRENT BERREY, D.M.D., P.A.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-04-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2082335362
|
| Plan sponsor’s
address |
1717 LANCE DR., POCATELLO, ID, 832044917
|
Plan administrator’s name and address
| Administrator’s EIN |
202442379 |
| Plan administrator’s name |
J. BRENT BERREY, D.M.D., P.A. |
| Plan administrator’s
address |
1717 LANCE DR., POCATELLO, ID, 832044917 |
| Administrator’s telephone number |
2082335362 |
Signature of
| Role |
Plan administrator |
| Date |
2011-02-01 |
| Name of individual signing |
JOHN BERREY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
J. BRENT BERREY, D.M.D., P.A. RETIREMENT PLAN
|
2009
|
202442379
|
2010-07-20
|
J. BRENT BERREY, D.M.D., P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-04-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2082335362
|
| Plan sponsor’s
address |
1717 LANCE DR., POCATELLO, ID, 832044917
|
Plan administrator’s name and address
| Administrator’s EIN |
202442379 |
| Plan administrator’s name |
J. BRENT BERREY, D.M.D., P.A. |
| Plan administrator’s
address |
1717 LANCE DR., POCATELLO, ID, 832044917 |
| Administrator’s telephone number |
2082335362 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-20 |
| Name of individual signing |
J. BRENT BERREY, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
