PLAZA DENTAL, P.A. EMPLOYEES' PROFIT SHARING PLAN
|
2019
|
410993086
|
2020-06-08
|
PLAZA DENTAL, P.A.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
17773 KENWOOD TRAIL, LAKEVILLE, MN, 55044
|
Signature of
Role |
Plan administrator |
Date |
2020-06-08 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-06-08 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PLAZA DENTAL, P.A. EMPLOYEES' PROFIT SHARING PLAN
|
2018
|
410993086
|
2019-03-04
|
PLAZA DENTAL, P.A.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
17773 KENWOOD TRAIL, LAKEVILLE, MN, 55044
|
Signature of
Role |
Plan administrator |
Date |
2019-03-04 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-03-04 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PLAZA DENTAL, P.A. EMPLOYEES' PROFIT SHARING PLAN
|
2017
|
410993086
|
2018-04-02
|
PLAZA DENTAL, P.A.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
17773 KENWOOD TRAIL, LAKEVILLE, MN, 55044
|
Signature of
Role |
Plan administrator |
Date |
2018-04-02 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-04-02 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PLAZA DENTAL, P.A. EMPLOYEES' PROFIT SHARING PLAN
|
2016
|
410993086
|
2018-04-02
|
PLAZA DENTAL, P.A.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
17773 KENWOOD TRAIL, LAKEVILLE, MN, 55044
|
Signature of
Role |
Plan administrator |
Date |
2018-04-02 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-04-02 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PLAZA DENTAL, P.A. EMPLOYEES' PROFIT SHARING PLAN
|
2015
|
410993086
|
2017-07-18
|
PLAZA DENTAL, P.A.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
17773 KENWOOD TRAIL, LAKEVILLE, MN, 55044
|
Signature of
Role |
Plan administrator |
Date |
2017-07-18 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-18 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PLAZA DENTAL, P.A. EMPLOYEES' PROFIT SHARING PLAN
|
2014
|
410993086
|
2017-02-01
|
PLAZA DENTAL, P.A.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
1601 EAST HIGHWAY 13, SUITE 105, BURNSVILLE, MN, 55337
|
Signature of
Role |
Plan administrator |
Date |
2017-02-01 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-02-01 |
Name of individual signing |
MICHAEL E BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PLAZA DENTAL, P.A. EMPLOYEES' PROFIT SHARING PLAN
|
2014
|
410993086
|
2016-06-29
|
PLAZA DENTAL, P.A.
|
12
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
1601 EAST HIGHWAY 13, SUITE 105, BURNSVILLE, MN, 55337
|
Signature of
Role |
Plan administrator |
Date |
2016-06-29 |
Name of individual signing |
MIKE BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-06-29 |
Name of individual signing |
MIKE BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PLAZA DENTAL, P.A. EMPLOYEES' PROFIT SHARING PLAN
|
2013
|
410993086
|
2015-02-05
|
PLAZA DENTAL, P.A.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
1601 EAST HIGHWAY 13, SUITE 105, BURNSVILLE, MN, 55337
|
Signature of
Role |
Plan administrator |
Date |
2015-02-04 |
Name of individual signing |
MICHAEL BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-02-04 |
Name of individual signing |
MICHAEL BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PLAZA DENTAL, P.A. EMPLOYEES' PROFIT SHARING PLAN
|
2012
|
410993086
|
2014-01-08
|
PLAZA DENTAL, P.A.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
1601 EAST HIGHWAY 13, SUITE 105, BURNSVILLE, MN, 55337
|
Signature of
Role |
Plan administrator |
Date |
2014-01-08 |
Name of individual signing |
MICHAEL BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-01-08 |
Name of individual signing |
MICHAEL BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PLAZA DENTAL, P.A. EMPLOYEES PROFIT SHARING PLAN
|
2011
|
410993086
|
2013-02-06
|
PLAZA DENTAL, P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1973-01-10
|
Business code |
621210
|
Sponsor’s telephone number |
9528905450
|
Plan sponsor’s
address |
1601 EAST HIGHWAY 13, SUITE 105, BURNSVILLE, MN, 55337
|
Plan administrator’s name and address
Administrator’s EIN |
410993086 |
Plan administrator’s name |
PLAZA DENTAL, P.A. |
Plan administrator’s
address |
1601 EAST HIGHWAY 13, SUITE 105, BURNSVILLE, MN, 55337 |
Administrator’s telephone number |
9528905450 |
Signature of
Role |
Plan administrator |
Date |
2013-02-06 |
Name of individual signing |
MICHAEL BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-02-06 |
Name of individual signing |
MICHAEL BERGSTEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|