PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST
|
2023
|
411572376
|
2024-07-30
|
NORTHFIELD FAMILY DENTAL, P.A.
|
31
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1987-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5076455264
|
Plan sponsor’s
address |
1501 CLINTON LANE, NORTHFIELD, MN, 55057
|
Signature of
Role |
Plan administrator |
Date |
2024-07-30 |
Name of individual signing |
JULI STANDFUSS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-07-30 |
Name of individual signing |
JULI STANDFUSS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST
|
2022
|
411572376
|
2023-09-20
|
NORTHFIELD FAMILY DENTAL, P.A.
|
31
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1987-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5076455264
|
Plan sponsor’s
address |
1501 CLINTON LANE, NORTHFIELD, MN, 55057
|
Signature of
Role |
Plan administrator |
Date |
2023-09-20 |
Name of individual signing |
JULI STANDFUSS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-20 |
Name of individual signing |
JULI STANDFUSS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST
|
2021
|
411572376
|
2022-06-14
|
NORTHFIELD FAMILY DENTAL, P.A.
|
28
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1987-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5076455264
|
Plan
sponsor’s DBA name |
PROFESSIONAL DENTAL GROUP
|
Plan sponsor’s
address |
1501 CLINTON LANE, NORTHFIELD, MN, 55057
|
Signature of
Role |
Plan administrator |
Date |
2022-06-14 |
Name of individual signing |
JULI STANDFUSS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-06-14 |
Name of individual signing |
JULI STANDFUSS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST
|
2020
|
411572376
|
2021-05-11
|
NORTHFIELD FAMILY DENTAL, P.A.
|
19
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1987-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5076455264
|
Plan sponsor’s
address |
1501 CLINTON LANE, NORTHFIELD, MN, 55057
|
Signature of
Role |
Plan administrator |
Date |
2021-05-11 |
Name of individual signing |
JULI STANDFUSS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-05-11 |
Name of individual signing |
JULI STANDFUSS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST
|
2019
|
411572376
|
2020-06-24
|
NORTHFIELD FAMILY DENTAL, P.A.
|
20
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1987-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5076455264
|
Plan
sponsor’s DBA name |
PROFESSIONAL DENTAL GROU
|
Plan sponsor’s
address |
1501 CLINTON LANE, NORTHFIELD, MN, 55057
|
Signature of
Role |
Plan administrator |
Date |
2020-06-24 |
Name of individual signing |
JULI STANDFUSS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|