|
LEAVITT FAMILY DENTISTRY 401(K) PLAN
|
2023
|
813050500
|
2024-07-01
|
LEAVITT FAMILY DENTISTRY, PLLC
|
18
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087462646
|
| Plan sponsor’s
address |
3326 4TH STREET, SUITE 1, LEWISTON, ID, 83501
|
Signature of
| Role |
Plan administrator |
| Date |
2024-07-01 |
| Name of individual signing |
ERIN LEAVITT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ERIN G. LEAVITT, DMD 401(K) PLAN
|
2022
|
813050500
|
2023-07-17
|
LEAVITT FAMILY DENTISTRY, PLLC
|
16
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087462646
|
| Plan sponsor’s
address |
3326 4TH STREET, SUITE 1, LEWISTON, ID, 83501
|
Signature of
| Role |
Plan administrator |
| Date |
2023-07-17 |
| Name of individual signing |
ERIN LEAVITT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ERIN G. LEAVITT, DMD 401(K) PLAN
|
2021
|
813050500
|
2022-05-09
|
LEAVITT FAMILY DENTISTRY, PLLC
|
16
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087462646
|
| Plan sponsor’s
address |
3326 4TH STREET, SUITE 1, LEWISTON, ID, 83501
|
Signature of
| Role |
Plan administrator |
| Date |
2022-05-09 |
| Name of individual signing |
ERIN LEAVITT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ERIN G. LEAVITT, DMD 401(K) PLAN
|
2020
|
813050500
|
2021-07-08
|
LEAVITT FAMILY DENTISTRY, PLLC
|
14
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087462646
|
| Plan sponsor’s
address |
3326 4TH STREET, SUITE 1, LEWISTON, ID, 83501
|
Signature of
| Role |
Plan administrator |
| Date |
2021-07-08 |
| Name of individual signing |
ERIN LEAVITT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ERIN G. LEAVITT, DMD 401(K) PLAN
|
2019
|
813050500
|
2020-05-06
|
LEAVITT FAMILY DENTISTRY, PLLC
|
12
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087462646
|
| Plan sponsor’s
address |
3326 4TH STREET, SUITE 1, LEWISTON, ID, 83501
|
Signature of
| Role |
Plan administrator |
| Date |
2020-05-06 |
| Name of individual signing |
ERIN LEAVITT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ERIN G. LEAVITT, DMD 401(K) PLAN
|
2018
|
813050500
|
2019-07-01
|
LEAVITT FAMILY DENTISTRY, PLLC
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087462646
|
| Plan sponsor’s
address |
3326 4TH STREET, SUITE 1, LEWISTON, ID, 83501
|
Signature of
| Role |
Plan administrator |
| Date |
2019-07-01 |
| Name of individual signing |
ERIN LEAVITT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ERIN G. LEAVITT, DMD 401(K) PLAN
|
2017
|
813050500
|
2018-07-20
|
LEAVITT FAMILY DENTISTRY, PLLC
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087462646
|
| Plan sponsor’s
address |
3326 4TH STREET, SUITE 1, LEWISTON, ID, 83501
|
Signature of
| Role |
Plan administrator |
| Date |
2018-07-20 |
| Name of individual signing |
ERIN LEAVITT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ERIN G. LEAVITT, DMD 401(K) PLAN
|
2016
|
813050500
|
2017-05-18
|
LEAVITT FAMILY DENTISTRY, PLLC
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2087462646
|
| Plan sponsor’s
address |
3326 4TH STREET, SUITE 1, LEWISTON, ID, 83501
|
Signature of
| Role |
Plan administrator |
| Date |
2017-05-18 |
| Name of individual signing |
ERIN LEAVITT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2017-05-18 |
| Name of individual signing |
ERIN LEAVITT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
