|
SARAH VLACH MD, PC 401(K) PLAN
|
2019
|
261492548
|
2020-06-26
|
SARAH VLACH MD, PC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2010-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2085690504
|
| Plan sponsor’s
address |
2730 HOMESTEAD LANE, IDAHO FALLS, ID, 83404
|
Signature of
| Role |
Plan administrator |
| Date |
2020-06-26 |
| Name of individual signing |
MARK HOLBROOK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2020-06-26 |
| Name of individual signing |
SARAH VLACH |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SARAH VLACH MD, PC 401(K) PLAN
|
2018
|
261492548
|
2019-06-26
|
SARAH VLACH MD, PC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2010-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2085690504
|
| Plan sponsor’s
address |
2730 HOMESTEAD LANE, IDAHO FALLS, ID, 83404
|
Signature of
| Role |
Plan administrator |
| Date |
2019-06-26 |
| Name of individual signing |
MARK HOLBROOK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2019-06-26 |
| Name of individual signing |
SARAH VLACH |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SARAH VLACH MD, PC 401(K) PLAN
|
2017
|
261492548
|
2018-05-30
|
SARAH VLACH MD, PC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2010-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2085690504
|
| Plan sponsor’s
address |
2730 HOMESTEAD LANE, IDAHO FALLS, ID, 83404
|
Signature of
| Role |
Plan administrator |
| Date |
2018-05-30 |
| Name of individual signing |
MARK HOLBROOK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2018-05-30 |
| Name of individual signing |
SARAH VLACH |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SARAH VLACHMD, PC 401(K) PLAN
|
2016
|
261492548
|
2017-07-18
|
SARAH VLACH MD, PC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2010-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2085690504
|
| Plan sponsor’s
address |
2730 HOMESTEAD LANE, IDAHO FALLS, ID, 83404
|
Signature of
| Role |
Plan administrator |
| Date |
2017-07-17 |
| Name of individual signing |
MARK HOLBROOK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2017-07-17 |
| Name of individual signing |
MARK HOLBROOK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SARAH VLACHMD, PC 401(K) PLAN
|
2015
|
261492548
|
2016-06-21
|
SARAH VLACH MD, PC
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2010-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2085354343
|
| Plan sponsor’s
address |
3155 CHANNING WAY, SUITE A, IDAHO FALLS, ID, 83404
|
Signature of
| Role |
Plan administrator |
| Date |
2016-06-20 |
| Name of individual signing |
MARK HOLBROOK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2016-06-20 |
| Name of individual signing |
SARAH VLACH MD PC |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
