PERIODONTAL HEALTH SPECIALISTS OF IDAHO

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1989-10-28
Business code	621210
Sponsor’s telephone number	2083859228
Plan sponsor’s address	140 EAST BOISE AVENUE, BOISE, ID, 83706

Signature of

Role	Plan administrator
Date	2023-07-26
Name of individual signing	JACK LINCKS
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1989-10-28
Business code	621210
Sponsor’s telephone number	2083859228
Plan sponsor’s address	140 EAST BOISE AVENUE, BOISE, ID, 83706

Signature of

Role	Plan administrator
Date	2022-10-13
Name of individual signing	JACK LINCKS
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1989-10-28
Business code	621210
Sponsor’s telephone number	2083859228
Plan sponsor’s address	140 EAST BOISE AVENUE, BOISE, ID, 83706

Signature of

Role	Plan administrator
Date	2021-10-11
Name of individual signing	JACK LINCKS
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1989-10-28
Business code	621210
Sponsor’s telephone number	2083859228
Plan sponsor’s address	140 EAST BOISE AVENUE, BOISE, ID, 83706

Signature of

Role	Plan administrator
Date	2020-09-23
Name of individual signing	JACK LINCKS
Valid signature	Filed with authorized/valid electronic signature

Loan Status Date	2021-09-24
Loan Status	Paid in Full
Loan Maturity in Months	60
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	212860
Loan Approval Amount (current)	212860
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	20132
Servicing Lender Name	D. L. Evans Bank
Servicing Lender Address	375 N Overland Ave, BURLEY, ID, 83318-3432
Rural or Urban Indicator	U
Hubzone	N
LMI	N
Business Age Description	Existing or more than 2 years old
Project Address	Boise, ADA, ID, 83706-4302
Project Congressional District	ID-02
Number of Employees	18
NAICS code	621210
Borrower Race	Unanswered
Borrower Ethnicity	Unknown/NotStated
Business Type	Partnership
Originating Lender ID	20132
Originating Lender Name	D. L. Evans Bank
Originating Lender Address	BURLEY, ID
Gender	Unanswered
Veteran	Unanswered
Forgiveness Amount	213892.23
Forgiveness Paid Date	2021-08-23

Loan Status Date	2021-02-23
Loan Status	Paid in Full
Loan Maturity in Months	24
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	193800
Loan Approval Amount (current)	193800
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	20132
Servicing Lender Name	D. L. Evans Bank
Servicing Lender Address	375 N Overland Ave, BURLEY, ID, 83318-3432
Rural or Urban Indicator	U
Hubzone	N
LMI	N
Business Age Description	Existing or more than 2 years old
Project Address	BOISE, ADA, ID, 83706-4302
Project Congressional District	ID-02
Number of Employees	20
NAICS code	621210
Borrower Race	Unanswered
Borrower Ethnicity	Unknown/NotStated
Business Type	Partnership
Originating Lender ID	20132
Originating Lender Name	D. L. Evans Bank
Originating Lender Address	BURLEY, ID
Gender	Unanswered
Veteran	Unanswered
Forgiveness Amount	195276.07
Forgiveness Paid Date	2021-01-26