GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2017
|
411410011
|
2018-04-30
|
GRANITE CITY DENTAL LABORATORY, INC.
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Signature of
Role |
Plan administrator |
Date |
2018-04-30 |
Name of individual signing |
KAREN YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CREATED FROM GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2016
|
411410011
|
2018-02-01
|
GRANITE CITY DENTAL LABORATORY, INC.
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Signature of
Role |
Plan administrator |
Date |
2018-02-01 |
Name of individual signing |
KAREN YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2016
|
411410011
|
2017-07-12
|
GRANITE CITY DENTAL LABORATORY, INC.
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Signature of
Role |
Plan administrator |
Date |
2017-07-12 |
Name of individual signing |
WILLIAM YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2015
|
411410011
|
2016-08-08
|
GRANITE CITY DENTAL LABORATORY, INC.
|
28
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Signature of
Role |
Plan administrator |
Date |
2016-08-08 |
Name of individual signing |
WILLIAM YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2014
|
411410011
|
2015-06-26
|
GRANITE CITY DENTAL LABORATORY, INC.
|
27
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Signature of
Role |
Plan administrator |
Date |
2015-06-26 |
Name of individual signing |
WILLIAM YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2013
|
411410011
|
2014-07-09
|
GRANITE CITY DENTAL LABORATORY, INC.
|
28
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Signature of
Role |
Plan administrator |
Date |
2014-07-09 |
Name of individual signing |
WILLIAM YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2012
|
411410011
|
2013-07-16
|
GRANITE CITY DENTAL LABORATORY, INC.
|
32
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Signature of
Role |
Plan administrator |
Date |
2013-07-16 |
Name of individual signing |
WILLIAM YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2011
|
411410011
|
2012-07-05
|
GRANITE CITY DENTAL LABORATORY, INC.
|
29
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Plan administrator’s name and address
Administrator’s EIN |
411410011 |
Plan administrator’s name |
GRANITE CITY DENTAL LABORATORY, INC. |
Plan administrator’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304 |
Administrator’s telephone number |
3202534825 |
Signature of
Role |
Plan administrator |
Date |
2012-07-05 |
Name of individual signing |
WILLIAM YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2010
|
411410011
|
2011-10-06
|
GRANITE CITY DENTAL LABORATORY, INC.
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621510
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s mailing address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Plan administrator’s name and address
Administrator’s EIN |
411410011 |
Plan administrator’s name |
GRANITE CITY DENTAL LABORATORY, INC. |
Plan administrator’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304 |
Administrator’s telephone number |
3202534825 |
Number of participants as of the end of the plan year
Active participants |
16 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
10 |
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 |
15 |
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 |
2011-10-06 |
Name of individual signing |
WILLIAM YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GRANITE CITY DENTAL LABORATORY, INC. PROFIT SHARING 401(K) PLAN
|
2009
|
411410011
|
2010-07-23
|
GRANITE CITY DENTAL LABORATORY, INC.
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621510
|
Sponsor’s telephone number |
3202534825
|
Plan sponsor’s mailing address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Plan sponsor’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304
|
Plan administrator’s name and address
Administrator’s EIN |
411410011 |
Plan administrator’s name |
GRANITE CITY DENTAL LABORATORY, INC. |
Plan administrator’s
address |
1109 7TH STREET SE, ST CLOUD, MN, 56304 |
Administrator’s telephone number |
3202534825 |
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 |
9 |
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 |
14 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-07-23 |
Name of individual signing |
WILLIAM YOUNG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|