|
LAKESHORE DENTAL 401(K) PLAN
|
2023
|
832129362
|
2024-05-10
|
LAKESHORE DENTAL
|
21
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
813000
|
| Sponsor’s telephone number |
6126018993
|
| Plan sponsor’s
address |
4700 CEDAR AVE S, MINNEAPOLIS, MN, 55407
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2024-05-10 |
| Name of individual signing |
QIAN LIU |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKESHORE DENTAL 401(K) PLAN
|
2022
|
832129362
|
2023-05-27
|
LAKESHORE DENTAL
|
13
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
813000
|
| Sponsor’s telephone number |
6126018993
|
| Plan sponsor’s
address |
4700 CEDAR AVE S, MINNEAPOLIS, MN, 55407
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2023-05-27 |
| Name of individual signing |
CHRISTINE RIMER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKESHORE DENTAL 401(K) PLAN
|
2021
|
832129362
|
2022-06-01
|
LAKESHORE DENTAL
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
813000
|
| Sponsor’s telephone number |
6126018993
|
| Plan sponsor’s
address |
4700 CEDAR AVE S, MINNEAPOLIS, MN, 55407
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2022-06-01 |
| Name of individual signing |
CHRISTINE RIMER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKESHORE DENTAL 401(K) PLAN
|
2020
|
832129362
|
2021-07-16
|
LAKESHORE DENTAL
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
813000
|
| Sponsor’s telephone number |
6126018993
|
| Plan sponsor’s
address |
4700 CEDAR AVE S, MINNEAPOLIS, MN, 55407
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2021-07-15 |
| Name of individual signing |
CAROL HO |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
