|
PINE RIDGE DENTAL 401(K) PROFIT SHARING PLAN
|
2012
|
412001754
|
2013-05-29
|
PINE RIDGE DENTAL, P.A.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6122709334
|
| Plan sponsor’s
address |
26273 SECOND STREET E, SUITE A, ZIMMERMAN, MN, 55398
|
Signature of
| Role |
Plan administrator |
| Date |
2013-05-29 |
| Name of individual signing |
JENNIFER NARR |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PINE RIDGE DENTAL 401(K) PROFIT SHARING PLAN
|
2012
|
412001754
|
2013-05-29
|
PINE RIDGE DENTAL, P.A.
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6122709334
|
| Plan sponsor’s
address |
26273 SECOND ST. EAST, SUITE A, ZIMMERMAN, MN, 55398
|
Signature of
| Role |
Plan administrator |
| Date |
2013-05-29 |
| Name of individual signing |
JENNIFER NARR |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PINE RIDGE DENTAL 401(K) PROFIT SHARING PLAN
|
2011
|
412001754
|
2012-09-24
|
PINE RIDGE DENTAL, P.A.
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6122709334
|
| Plan sponsor’s
address |
26273 SECOND ST. EAST, SUITE A, ZIMMERMAN, MN, 55398
|
Plan administrator’s name and address
| Administrator’s EIN |
412001754 |
| Plan administrator’s name |
PINE RIDGE DENTAL, P.A. |
| Plan administrator’s
address |
26273 SECOND ST. EAST, SUITE A, ZIMMERMAN, MN, 55398 |
| Administrator’s telephone number |
6122709334 |
Signature of
| Role |
Plan administrator |
| Date |
2012-09-24 |
| Name of individual signing |
BUDDY HORNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
