|
ST. PAUL ORAL SURGERY, P.A. PROFIT SHARING PLAN
|
2012
|
410956300
|
2013-05-18
|
ST. PAUL ORAL SURGERY, P.A.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1970-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6514511873
|
| Plan sponsor’s mailing address |
750 MAIN STREET, SUITE 203, MENDOTA HEIGHTS, MN, 55118
|
| Plan sponsor’s
address |
750 MAIN STREET, SUITE 203, MENDOTA HEIGHTS, MN, 55118
|
Plan administrator’s name and address
| Administrator’s EIN |
410956300 |
| Plan administrator’s name |
ST. PAUL ORAL SURGERY, P.A. |
| Plan administrator’s
address |
750 MAIN STREET, SUITE 203, MENDOTA HEIGHTS, MN, 55118 |
| Administrator’s telephone number |
6514511873 |
Number of participants as of the end of the plan year
| Active participants |
22 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
2 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
1 |
| Number of
participants
with
account balances as of the end of the plan year |
18 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
| Role |
Plan administrator |
| Date |
2013-05-18 |
| Name of individual signing |
CHARLES TENTINGER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ST. PAUL ORAL SURGERY, P.A. PROFIT SHARING PLAN
|
2011
|
410956300
|
2012-06-13
|
ST. PAUL ORAL SURGERY, P.A.
|
18
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1970-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6514511873
|
| Plan sponsor’s mailing address |
750 MAIN STREET, SUITE 203, MENDOTA HEIGHTS, MN, 55118
|
| Plan sponsor’s
address |
750 MAIN STREET, SUITE 203, MENDOTA HEIGHTS, MN, 55118
|
Plan administrator’s name and address
| Administrator’s EIN |
410956300 |
| Plan administrator’s name |
ST. PAUL ORAL SURGERY, P.A. |
| Plan administrator’s
address |
750 MAIN STREET, SUITE 203, MENDOTA HEIGHTS, MN, 55118 |
| Administrator’s telephone number |
6514511873 |
Number of participants as of the end of the plan year
| Active participants |
15 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
2 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
17 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2012-06-13 |
| Name of individual signing |
RICHARD WEISBECKER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ST. PAUL ORAL SURGERY, P.A. PROFIT SHARING PLAN
|
2010
|
410956300
|
2011-06-27
|
ST. PAUL ORAL SURGERY, P.A.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1970-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6514511873
|
| Plan sponsor’s mailing address |
750 MAIN STREET, SUITE 203, MENDOTA HEIGHTS, MN, 55118
|
| Plan sponsor’s
address |
750 MAIN STREET, SUITE 203, MENDOTA HEIGHTS, MN, 55118
|
Plan administrator’s name and address
| Administrator’s EIN |
410956300 |
| Plan administrator’s name |
ST. PAUL ORAL SURGERY, P.A. |
| Plan administrator’s
address |
750 MAIN STREET, SUITE 203, MENDOTA HEIGHTS, MN, 55118 |
| Administrator’s telephone number |
6514511873 |
Number of participants as of the end of the plan year
| Active participants |
15 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
3 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
17 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-06-27 |
| Name of individual signing |
RICHARD WEISBECKER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ST. PAUL ORAL SURGERY, P.A. PROFIT SHARING PLAN
|
2009
|
410956300
|
2011-01-31
|
ST. PAUL ORAL SURGERY, P.A.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1970-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6514511873
|
| Plan sponsor’s mailing address |
2550 UNIVERSITY AVE., WEST, SUITE 115-N, ST. PAUL, MN, 55114
|
| Plan sponsor’s
address |
2550 UNIVERSITY AVE., WEST, SUITE 115-N, ST. PAUL, MN, 55114
|
Plan administrator’s name and address
| Administrator’s EIN |
410956300 |
| Plan administrator’s name |
ST. PAUL ORAL SURGERY, P.A. |
| Plan administrator’s
address |
2550 UNIVERSITY AVE., WEST, SUITE 115-N, ST. PAUL, MN, 55114 |
| Administrator’s telephone number |
6514511873 |
Number of participants as of the end of the plan year
| Active participants |
14 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
3 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
17 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-01-31 |
| Name of individual signing |
RICHARD WEISBECKER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
