|
SKIN SPECIALISTS, LTD RETIREMENT PLAN
|
2015
|
410954207
|
2016-06-13
|
SKIN SPECIALISTS, LTD
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-07-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6123380711
|
| Plan sponsor’s
address |
825 NICOLLET MALL, MEDICAL ARTS BUILDING, SUITE 1002, MINNEAPOLIS, MN, 55420
|
Signature of
| Role |
Plan administrator |
| Date |
2016-06-13 |
| Name of individual signing |
BRIAN ZELICKSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2016-06-13 |
| Name of individual signing |
BRIAN ZELICKSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SKIN SPECIALISTS, LTD RETIREMENT PLAN
|
2014
|
410954207
|
2016-01-08
|
SKIN SPECIALISTS, LTD
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-07-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6123380711
|
| Plan sponsor’s
address |
825 NICOLLET MALL, MEDICAL ARTS BUILDING, SUITE 1002, MINNEAPOLIS, MN, 55420
|
Signature of
| Role |
Plan administrator |
| Date |
2016-01-08 |
| Name of individual signing |
BRIAN ZELICKSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2016-01-08 |
| Name of individual signing |
BRIAN ZELICKSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SKIN SPECIALISTS, LTD RETIREMENT PLAN
|
2013
|
410954207
|
2014-12-10
|
SKIN SPECIALISTS, LTD
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-07-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6123380711
|
| Plan sponsor’s
address |
825 NICOLLET MALL, MEDICAL ARTS BUILDING, SUITE 1002, MINNEAPOLIS, MN, 55420
|
Signature of
| Role |
Plan administrator |
| Date |
2014-12-10 |
| Name of individual signing |
ALVIN ZELICKSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SKIN SPECIALISTS, LTD RETIREMENT PLAN
|
2012
|
410954207
|
2013-12-02
|
SKIN SPECIALISTS, LTD
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-07-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6123380711
|
| Plan sponsor’s
address |
825 NICOLLET MALL, MEDICAL ARTS BUILDING, SUITE 1002, MINNEAPOLIS, MN, 55420
|
Signature of
| Role |
Plan administrator |
| Date |
2013-12-02 |
| Name of individual signing |
ALVIN ZELICKSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SKIN SPECIALISTS, LTD RETIREMENT PLAN
|
2011
|
410954207
|
2012-12-12
|
SKIN SPECIALISTS, LTD
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-07-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6123380711
|
| Plan sponsor’s
address |
825 NICOLLET MALL, MEDICAL ARTS BUILDING, SUITE 1002, MINNEAPOLIS, MN, 55420
|
Plan administrator’s name and address
| Administrator’s EIN |
410954207 |
| Plan administrator’s name |
SKIN SPECIALISTS, LTD |
| Plan administrator’s
address |
825 NICOLLET MALL, MEDICAL ARTS BUILDING, SUITE 1002, MINNEAPOLIS, MN, 55420 |
| Administrator’s telephone number |
6123380711 |
Signature of
| Role |
Plan administrator |
| Date |
2012-12-12 |
| Name of individual signing |
ALVIN ZELICKSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
