|
CARLSON DISTINCTIVE DENTISTRY, PLLC 401(K) PROFIT SHARING PLAN
|
2023
|
830574695
|
2024-07-18
|
CARLSON DISTINCTIVE DENTISTRY, PLLC
|
16
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6514398840
|
| Plan
sponsor’s DBA name |
CARLSON DENTAL GROUP
|
| Plan sponsor’s
address |
1701 CURVE CREST BLVD, SUITE 100, STILLWATER, MN, 55082
|
Signature of
| Role |
Plan administrator |
| Date |
2024-07-18 |
| Name of individual signing |
HALDEN PETERSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CARLSON DISTINCTIVE DENTISTRY, PLLC 401(K) PROFIT SHARING PLAN
|
2022
|
830574695
|
2023-09-30
|
CARLSON DISTINCTIVE DENTISTRY, PLLC
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6514398840
|
| Plan
sponsor’s DBA name |
CARLSON DENTAL GROUP
|
| Plan sponsor’s
address |
1701 CURVE CREST BLVD, SUITE 100, STILLWATER, MN, 55082
|
Signature of
| Role |
Plan administrator |
| Date |
2023-10-01 |
| Name of individual signing |
SARAH CARLSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CARLSON DISTINCTIVE DENTISTRY, PLLC 401(K) PROFIT SHARING PLAN
|
2021
|
830574695
|
2022-06-09
|
CARLSON DISTINCTIVE DENTISTRY, PLLC
|
13
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6514724713
|
| Plan
sponsor’s DBA name |
DBA CARLSON DENTAL GROUP
|
| Plan sponsor’s
address |
1701 CURVE CREST BOULEVARD, SUITE 100, STILLWATER, MN, 55082
|
Signature of
| Role |
Plan administrator |
| Date |
2022-06-09 |
| Name of individual signing |
SARAH CARLSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CARLSON DISTINCTIVE DENTISTRY, PLLC 401(K) PROFIT SHARING PLAN
|
2019
|
830574695
|
2020-07-24
|
CARLSON DISTINCTIVE DENTISTRY, PLLC
|
15
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6514398840
|
| Plan sponsor’s
address |
1701 CURVE CREST BLVD, STILLWATER, MN, 55082
|
Signature of
| Role |
Plan administrator |
| Date |
2020-07-24 |
| Name of individual signing |
SARAH CARLSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CARLSON DISTINCTIVE DENTISTRY, PLLC 401(K) PROFIT SHARING PLAN
|
2018
|
830574695
|
2019-10-09
|
CARLSON DISTINCTIVE DENTISTRY, PLLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6514398840
|
| Plan sponsor’s
address |
1701 CURVE CREST BLVD, STILLWATER, MN, 55082
|
Signature of
| Role |
Plan administrator |
| Date |
2019-10-09 |
| Name of individual signing |
SARAH CARLSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
