|
JEFFREY H. MILLER D.D.S., P.A. PROFIT SHARING PLAN AND TRUST
|
2012
|
411388734
|
2013-06-04
|
JEFFREY H. MILLER D.D.S., P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9529416276
|
| Plan sponsor’s
address |
5559 W. 70TH STREET, EDINA, MN, 55439
|
Signature of
| Role |
Plan administrator |
| Date |
2013-06-04 |
| Name of individual signing |
JEFFREY H. MILLER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JEFFREY H. MILLER D.D.S., P.A. PROFIT SHARING PLAN AND TRUST
|
2011
|
411388734
|
2012-06-27
|
JEFFREY H. MILLER D.D.S., P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9529299450
|
| Plan sponsor’s
address |
3345 DAKOTA AVENUE SOUTH, ST. LOUIS PARK, MN, 554162039
|
Plan administrator’s name and address
| Administrator’s EIN |
411388734 |
| Plan administrator’s name |
JEFFREY H. MILLER D.D.S., P.A. |
| Plan administrator’s
address |
3345 DAKOTA AVENUE SOUTH, ST. LOUIS PARK, MN, 554162039 |
| Administrator’s telephone number |
9529299450 |
Signature of
| Role |
Plan administrator |
| Date |
2012-06-27 |
| Name of individual signing |
JEFFREY H. MILLER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JEFFREY H. MILLER D.D.S., P.A. PROFIT SHARING PLAN AND TRUST
|
2010
|
411388734
|
2011-09-28
|
JEFFREY H. MILLER D.D.S., P.A.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9529299450
|
| Plan sponsor’s
address |
3345 DAKOTA AVENUE SOUTH, ST. LOUIS PARK, MN, 554162039
|
Plan administrator’s name and address
| Administrator’s EIN |
411388734 |
| Plan administrator’s name |
JEFFREY H. MILLER D.D.S., P.A. |
| Plan administrator’s
address |
3345 DAKOTA AVENUE SOUTH, ST. LOUIS PARK, MN, 554162039 |
| Administrator’s telephone number |
9529299450 |
Signature of
| Role |
Plan administrator |
| Date |
2011-09-27 |
| Name of individual signing |
JEFFREY H. MILLER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JEFFREY H. MILLER D.D.S., P.A. PROFIT SHARING PLAN AND TRUST
|
2009
|
411388734
|
2010-10-06
|
JEFFREY H. MILLER D.D.S., P.A.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9529299450
|
| Plan sponsor’s
address |
3345 DAKOTA AVENUE SOUTH, ST. LOUIS PARK, MN, 554162039
|
Plan administrator’s name and address
| Administrator’s EIN |
411388734 |
| Plan administrator’s name |
JEFFREY H. MILLER D.D.S., P.A. |
| Plan administrator’s
address |
3345 DAKOTA AVENUE SOUTH, ST. LOUIS PARK, MN, 554162039 |
| Administrator’s telephone number |
9529299450 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-06 |
| Name of individual signing |
JEFFREY H. MILLER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
