|
GENESIS LONGEVITY CENTER, PLLC 401(K) PS PLAN
|
2020
|
474213181
|
2021-03-22
|
GENESIS LONGEVITY CENTER, PLLC
|
16
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2089393505
|
| Plan sponsor’s
address |
951 E. PLAZA DRIVE, STE 170, EAGLE, ID, 83616
|
Plan administrator’s name and address
| Administrator’s EIN |
474213181 |
| Plan administrator’s name |
GENESIS LONGEVITY CENTER, PLLC |
| Plan administrator’s
address |
951 E. PLAZA DRIVE, STE 370, EAGLE, ID, 83616 |
| Administrator’s telephone number |
2089393505 |
Signature of
| Role |
Plan administrator |
| Date |
2021-03-22 |
| Name of individual signing |
TAMARA SIMON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GENESIS LONGEVITY CENTER, PLLC 401(K) PS PLAN
|
2019
|
474213181
|
2020-10-07
|
GENESIS LONGEVITY CENTER, PLLC
|
16
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2089393505
|
| Plan sponsor’s
address |
951 E. PLAZA DRIVE, STE 170, EAGLE, ID, 83616
|
Plan administrator’s name and address
| Administrator’s EIN |
474213181 |
| Plan administrator’s name |
GENESIS LONGEVITY CENTER, PLLC |
| Plan administrator’s
address |
951 E. PLAZA DRIVE, STE 370, EAGLE, ID, 83616 |
| Administrator’s telephone number |
2089393505 |
Signature of
| Role |
Plan administrator |
| Date |
2020-10-07 |
| Name of individual signing |
TAMARA SIMON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GENESIS LONGEVITY CENTER, PLLC 401(K) PS PLAN
|
2018
|
474213181
|
2019-10-14
|
GENESIS LONGEVITY CENTER, PLLC
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2089393505
|
| Plan sponsor’s
address |
951 E. PLAZA DRIVE, STE 170, EAGLE, ID, 83616
|
Plan administrator’s name and address
| Administrator’s EIN |
474213181 |
| Plan administrator’s name |
GENESIS LONGEVITY CENTER, PLLC |
| Plan administrator’s
address |
951 E. PLAZA DRIVE, STE 370, EAGLE, ID, 83616 |
| Administrator’s telephone number |
2089393505 |
Signature of
| Role |
Plan administrator |
| Date |
2019-10-14 |
| Name of individual signing |
TAMARA SIMON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GENESIS LONGEVITY CENTER, PLLC 401(K) PS PLAN
|
2017
|
474213181
|
2018-08-09
|
GENESIS LONGEVITY CENTER, PLLC
|
20
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2089393505
|
| Plan sponsor’s
address |
951 E. PLAZA DRIVE, STE 170, EAGLE, ID, 83616
|
Plan administrator’s name and address
| Administrator’s EIN |
474213181 |
| Plan administrator’s name |
GENESIS LONGEVITY CENTER, PLLC |
| Plan administrator’s
address |
951 E. PLAZA DRIVE, STE 370, EAGLE, ID, 83616 |
| Administrator’s telephone number |
2089393505 |
Signature of
| Role |
Plan administrator |
| Date |
2018-08-09 |
| Name of individual signing |
TAMARA SIMON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
