CAPITOL SURGERY, PLLC
|
2012
|
204138713
|
2013-08-14
|
CAPITOL SURGERY, PLLC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6513519488
|
Plan sponsor’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082
|
Plan administrator’s name and address
Administrator’s EIN |
204138713 |
Plan administrator’s name |
CAPITOL SURGERY, PLLC |
Plan administrator’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082 |
Administrator’s telephone number |
6513519488 |
Signature of
Role |
Plan administrator |
Date |
2013-08-14 |
Name of individual signing |
BARBARA STEINBRUNN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL SURGERY, PLLC 401(K) P/S PLAN
|
2012
|
204138713
|
2013-06-13
|
CAPITOL SURGERY, PLLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6513519488
|
Plan sponsor’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082
|
Plan administrator’s name and address
Administrator’s EIN |
204138713 |
Plan administrator’s name |
CAPITOL SURGERY, PLLC |
Plan administrator’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082 |
Administrator’s telephone number |
6513519488 |
Signature of
Role |
Plan administrator |
Date |
2013-06-13 |
Name of individual signing |
BARBARA STEINBRUNN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL SURGERY, PLLC 401(K) P/S PLAN
|
2011
|
204138713
|
2012-06-18
|
CAPITOL SURGERY, PLLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6513519488
|
Plan sponsor’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082
|
Plan administrator’s name and address
Administrator’s EIN |
204138713 |
Plan administrator’s name |
CAPITOL SURGERY, PLLC |
Plan administrator’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082 |
Administrator’s telephone number |
6513519488 |
Signature of
Role |
Plan administrator |
Date |
2012-06-18 |
Name of individual signing |
BARBARA STEINBRUNN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL SURGERY, PLLC 401(K) P/S PLAN
|
2010
|
204138713
|
2011-05-20
|
CAPITOL SURGERY, PLLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6513519488
|
Plan sponsor’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082
|
Plan administrator’s name and address
Administrator’s EIN |
204138713 |
Plan administrator’s name |
CAPITOL SURGERY, PLLC |
Plan administrator’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082 |
Administrator’s telephone number |
6513519488 |
Signature of
Role |
Plan administrator |
Date |
2011-05-20 |
Name of individual signing |
BARBARA STEINBRUNN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL SURGERY, PLLC 401(K) P/S PLAN
|
2009
|
204138713
|
2010-08-26
|
CAPITOL SURGERY, PLLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6513519488
|
Plan sponsor’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082
|
Plan administrator’s name and address
Administrator’s EIN |
204138713 |
Plan administrator’s name |
CAPITOL SURGERY, PLLC |
Plan administrator’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082 |
Administrator’s telephone number |
6513519488 |
Signature of
Role |
Plan administrator |
Date |
2010-08-26 |
Name of individual signing |
BARBARA STEINBRUNN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL SURGERY, PLLC 401(K) P/S PLAN
|
2009
|
204138713
|
2010-08-26
|
CAPITOL SURGERY, PLLC
|
2
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6513519488
|
Plan sponsor’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082
|
Plan administrator’s name and address
Administrator’s EIN |
204138713 |
Plan administrator’s name |
CAPITOL SURGERY, PLLC |
Plan administrator’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082 |
Administrator’s telephone number |
6513519488 |
Signature of
Role |
Plan administrator |
Date |
2010-08-26 |
Name of individual signing |
BARBARA STEINBRUNN |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
CAPITOL SURGERY, PLLC 401(K) P/S PLAN
|
2009
|
204138713
|
2010-08-26
|
CAPITOL SURGERY, PLLC
|
2
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6513519488
|
Plan sponsor’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082
|
Plan administrator’s name and address
Administrator’s EIN |
204138713 |
Plan administrator’s name |
CAPITOL SURGERY, PLLC |
Plan administrator’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082 |
Administrator’s telephone number |
6513519488 |
Signature of
Role |
Plan administrator |
Date |
2010-08-26 |
Name of individual signing |
BARBARA STEINBRUNN |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
CAPITOL SURGERY, PLLC 401(K) P/S PLAN
|
2009
|
204138713
|
2010-08-26
|
CAPITOL SURGERY, PLLC
|
2
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6513519488
|
Plan sponsor’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082
|
Plan administrator’s name and address
Administrator’s EIN |
204138713 |
Plan administrator’s name |
CAPITOL SURGERY, PLLC |
Plan administrator’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082 |
Administrator’s telephone number |
6513519488 |
Signature of
Role |
Plan administrator |
Date |
2010-08-26 |
Name of individual signing |
BARBARA STEINBRUNN |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
CAPITOL SURGERY, PLLC 401(K) P/S PLAN
|
2009
|
204138713
|
2010-08-26
|
CAPITOL SURGERY, PLLC
|
2
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6513519488
|
Plan sponsor’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082
|
Plan administrator’s name and address
Administrator’s EIN |
204138713 |
Plan administrator’s name |
CAPITOL SURGERY, PLLC |
Plan administrator’s
address |
12149 QUAIL AVENUE N, STILLWATER, MN, 55082 |
Administrator’s telephone number |
6513519488 |
Signature of
Role |
Plan administrator |
Date |
2010-08-26 |
Name of individual signing |
BARBARA SCHMIDT STEINBRUNN |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|