CAPITOL NEUROLOGY, P.A. PROFIT SHARING PLAN
|
2013
|
411605814
|
2014-03-05
|
CAPITOL NEUROLOGY, P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-03-14
|
Business code |
621111
|
Sponsor’s telephone number |
6512911559
|
Plan sponsor’s
address |
20 LAKE CT, ST. PAUL, MN, 55127
|
Signature of
Role |
Plan administrator |
Date |
2014-03-05 |
Name of individual signing |
NEIL DAHLQUIST |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-03-05 |
Name of individual signing |
NEIL DAHLQUIST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL NEUROLOGY, P.A. PROFIT SHARING PLAN
|
2012
|
411605814
|
2013-10-08
|
CAPITOL NEUROLOGY, P.A.
|
8
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-03-14
|
Business code |
621111
|
Sponsor’s telephone number |
6512911559
|
Plan sponsor’s
address |
360 SHERMAN STREET, SUITE 350, FORT ROAD MEDICAL BUILDING, ST. PAUL, MN, 55102
|
Signature of
Role |
Plan administrator |
Date |
2013-10-08 |
Name of individual signing |
NEIL DAHLQUIST MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-08 |
Name of individual signing |
NEIL DAHLQUIST MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL NEUROLOGY, P.A. PROFIT SHARING PLAN
|
2012
|
411605814
|
2013-10-08
|
CAPITOL NEUROLOGY, P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-03-14
|
Business code |
621111
|
Sponsor’s telephone number |
6512911559
|
Plan sponsor’s
address |
360 SHERMAN STREET, SUITE 350, FORT ROAD MEDICAL BUILDING, ST. PAUL, MN, 55102
|
Signature of
Role |
Plan administrator |
Date |
2013-10-08 |
Name of individual signing |
NEIL DAHLQUIST MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-08 |
Name of individual signing |
NEIL DAHLQUIST MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL NEUROLOGY, P.A. PROFIT SHARING PLAN
|
2011
|
411605814
|
2012-07-04
|
CAPITOL NEUROLOGY, P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-03-14
|
Business code |
621111
|
Sponsor’s telephone number |
6512911559
|
Plan sponsor’s
address |
360 SHERMAN STREET, SUITE 350, FORT ROAD MEDICAL BUILDING, ST. PAUL, MN, 55102
|
Plan administrator’s name and address
Administrator’s EIN |
411605814 |
Plan administrator’s name |
CAPITOL NEUROLOGY, P.A. |
Plan administrator’s
address |
360 SHERMAN STREET, SUITE 350, FORT ROAD MEDICAL BUILDING, ST. PAUL, MN, 55102 |
Administrator’s telephone number |
6512911559 |
Signature of
Role |
Plan administrator |
Date |
2012-07-04 |
Name of individual signing |
NEIL DAHLQUIST |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-04 |
Name of individual signing |
NEIL DAHLQUIST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL NEUROLOGY, P.A. PROFIT SHARING PLAN
|
2010
|
411605814
|
2011-05-10
|
CAPITOL NEUROLOGY, P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-03-14
|
Business code |
621111
|
Sponsor’s telephone number |
6512911559
|
Plan sponsor’s
address |
360 SHERMAN STREET, SUITE 350, FORT ROAD MEDICAL BUILDING, ST. PAUL, MN, 55102
|
Plan administrator’s name and address
Administrator’s EIN |
411605814 |
Plan administrator’s name |
CAPITOL NEUROLOGY, P.A. |
Plan administrator’s
address |
360 SHERMAN STREET, SUITE 350, FORT ROAD MEDICAL BUILDING, ST. PAUL, MN, 55102 |
Administrator’s telephone number |
6512911559 |
Signature of
Role |
Plan administrator |
Date |
2011-05-10 |
Name of individual signing |
NEIL R. DAHLQUIST, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-05-10 |
Name of individual signing |
NEIL R. DAHLQUIST, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITOL NEUROLOGY, P.A. PROFIT SHARING PLAN
|
2009
|
411605814
|
2010-09-29
|
CAPITOL NEUROLOGY, P.A.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-03-14
|
Business code |
621111
|
Sponsor’s telephone number |
6512911559
|
Plan sponsor’s
address |
360 SHERMAN STREET, SUITE 350, FORT ROAD MEDICAL BUILDING, ST. PAUL, MN, 55102
|
Plan administrator’s name and address
Administrator’s EIN |
411605814 |
Plan administrator’s name |
CAPITOL NEUROLOGY, P.A. |
Plan administrator’s
address |
360 SHERMAN STREET, SUITE 350, FORT ROAD MEDICAL BUILDING, ST. PAUL, MN, 55102 |
Administrator’s telephone number |
6512911559 |
Signature of
Role |
Plan administrator |
Date |
2010-09-29 |
Name of individual signing |
NEIL R. DAHLQUIST MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-09-29 |
Name of individual signing |
NEIL R. DAHLQUIST MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|