THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2023
|
260845729
|
2024-09-16
|
THOMAS L. BLAISDELL DDS PC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
3611 S 10TH AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2024-09-16 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2022
|
260845729
|
2023-08-07
|
THOMAS L. BLAISDELL DDS PC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
3611 S 10TH AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2023-08-07 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2021
|
260845729
|
2022-10-03
|
THOMAS L. BLAISDELL DDS PC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
3611 S 10TH AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2022-10-03 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2020
|
260845729
|
2021-10-11
|
THOMAS L. BLAISDELL DDS PC
|
8
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
3611 S 10TH AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2021-10-11 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2020
|
260845729
|
2023-01-16
|
THOMAS L. BLAISDELL DDS PC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
3611 S 10TH AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2023-01-16 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2019
|
260845729
|
2020-09-23
|
THOMAS L. BLAISDELL DDS PC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
3611 S 10TH AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2020-09-23 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2018
|
260845729
|
2019-10-08
|
THOMAS L. BLAISDELL DDS PC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
3611 S 10TH AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2019-10-08 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2017
|
260845729
|
2018-09-13
|
THOMAS L. BLAISDELL DDS PC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
3611 S 10TH AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2018-09-13 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2016
|
260845729
|
2017-08-31
|
THOMAS L. BLAISDELL DDS PC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
1916 ELLIS AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2017-08-31 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THOMAS L. BLAISDELL DDS PC 401(K) PLAN
|
2015
|
260845729
|
2016-09-21
|
THOMAS L. BLAISDELL DDS PC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2014-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2084592376
|
Plan sponsor’s
address |
1916 ELLIS AVE., CALDWELL, ID, 83605
|
Signature of
Role |
Plan administrator |
Date |
2016-09-21 |
Name of individual signing |
THOMAS L. BLAISDELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|