MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2020
|
870698736
|
2021-01-27
|
MICHAEL D. SUFKA O.D., P.A.
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
Signature of
Role |
Plan administrator |
Date |
2021-01-27 |
Name of individual signing |
MICHAEL D. SUFKA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2019
|
870698736
|
2020-07-21
|
MICHAEL D. SUFKA O.D., P.A.
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
|
MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2018
|
870698736
|
2019-07-23
|
MICHAEL D. SUFKA O.D., P.A.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
Signature of
Role |
Plan administrator |
Date |
2019-07-23 |
Name of individual signing |
MICHAEL D. SUFKA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2017
|
870698736
|
2018-05-11
|
MICHAEL D. SUFKA O.D., P.A.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
Signature of
Role |
Plan administrator |
Date |
2018-05-11 |
Name of individual signing |
MICHAEL D. SUFKA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2016
|
870698736
|
2017-06-16
|
MICHAEL D. SUFKA O.D., P.A.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
Signature of
Role |
Plan administrator |
Date |
2017-06-16 |
Name of individual signing |
MICHAEL D. SUFKA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2015
|
870698736
|
2016-08-01
|
MICHAEL D. SUFKA O.D., P.A.
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
Signature of
Role |
Plan administrator |
Date |
2016-08-01 |
Name of individual signing |
MICHAEL D. SUFKA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2014
|
870698736
|
2015-10-07
|
MICHAEL D. SUFKA O.D., P.A.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
Signature of
Role |
Plan administrator |
Date |
2015-10-07 |
Name of individual signing |
MICHAEL D. SUFKA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2013
|
870698736
|
2014-07-31
|
MICHAEL D. SUFKA O.D., P.A.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
Signature of
Role |
Plan administrator |
Date |
2014-07-31 |
Name of individual signing |
MICHAEL D. SUFKA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2012
|
870698736
|
2013-10-10
|
MICHAEL D. SUFKA O.D., P.A.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
Plan administrator’s name and address
Administrator’s EIN |
870698736 |
Plan administrator’s name |
MICHAEL D. SUFKA O.D., P.A. |
Plan administrator’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303 |
Administrator’s telephone number |
3202532441 |
Signature of
Role |
Plan administrator |
Date |
2013-10-10 |
Name of individual signing |
MICHAEL D. SUFKA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. SUFKA O.D., P.A. 401(K) PLAN
|
2011
|
870698736
|
2012-07-31
|
MICHAEL D. SUFKA O.D., P.A.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3202532441
|
Plan sponsor’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303
|
Plan administrator’s name and address
Administrator’s EIN |
870698736 |
Plan administrator’s name |
MICHAEL D. SUFKA O.D., P.A. |
Plan administrator’s
address |
1545 NORTHWAY DRIVE, SUITE 120, ST. CLOUD, MN, 56303 |
Administrator’s telephone number |
3202532441 |
Signature of
Role |
Plan administrator |
Date |
2012-07-31 |
Name of individual signing |
MICHAEL D. SUFKA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|