LENSAR GROUP EMPLOYEE BENEFITS
|
2023
|
320125724
|
2024-07-29
|
LENSAR, INC.
|
120
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2023-05-01
|
Business code |
339110
|
Sponsor’s telephone number |
8885367271
|
Plan sponsor’s mailing address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010
|
Plan sponsor’s
address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-29 |
Name of individual signing |
NICHOLAS CURTIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-07-29 |
Name of individual signing |
NICHOLAS CURTIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LENSAR GROUP EMPLOYEE BENEFITS
|
2022
|
320125724
|
2023-07-20
|
LENSAR, INC.
|
105
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2022-05-01
|
Business code |
339110
|
Sponsor’s telephone number |
8885367271
|
Plan sponsor’s mailing address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010
|
Plan sponsor’s
address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010
|
Number of participants as of the end of the plan year
Active participants |
107 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2023-07-20 |
Name of individual signing |
NICHOLAS CURTIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-07-20 |
Name of individual signing |
NICHOLAS CURTIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LENSAR, INC. 401(K) PLAN
|
2022
|
320125724
|
2023-09-19
|
LENSAR, INC.
|
117
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2021-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8885367271
|
Plan sponsor’s
address |
2800 DISCOVERY DRIVE, SUITE 100, ORLANDO, FL, 32826
|
|
LENSAR, INC. 401(K) PLAN
|
2021
|
320125724
|
2022-11-16
|
LENSAR, INC.
|
100
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2021-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8885367271
|
Plan sponsor’s
address |
2800 DISCOVERY DRIVE, SUITE 100, ORLANDO, FL, 32826
|
|
LENSAR INC 401 K PROFIT SHARING PLAN TRUST
|
2015
|
320125724
|
2016-06-28
|
LENSAR INC
|
116
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
4075834241
|
Plan sponsor’s
address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010
|
Signature of
Role |
Plan administrator |
Date |
2016-06-28 |
Name of individual signing |
CARI DAVIDSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LENSAR, INC.
|
2014
|
320125724
|
2015-10-29
|
LENSAR, INC.
|
102
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2014-07-01
|
Business code |
339110
|
Sponsor’s telephone number |
4075834241
|
Plan
sponsor’s DBA name |
LENSAR
|
Plan sponsor’s mailing address |
2800 DISCOVERY DRIVE, SUITE 100, ORLANDO, FL, 32826
|
Plan sponsor’s
address |
2800 DISCOVERY DRIVE, SUITE 100, ORLANDO, FL, 32826
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-29 |
Name of individual signing |
CARI DAVIDSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-29 |
Name of individual signing |
CARI DAVIDSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LENSAR INC 401 K PROFIT SHARING PLAN TRUST
|
2014
|
320125724
|
2015-06-16
|
LENSAR INC
|
103
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
4075834241
|
Plan sponsor’s
address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010
|
Signature of
Role |
Plan administrator |
Date |
2015-06-16 |
Name of individual signing |
CARI DAVIDSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LENSAR INC 401 K PROFIT SHARING PLAN TRUST
|
2013
|
320125724
|
2014-06-25
|
LENSAR INC
|
89
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
4075834241
|
Plan sponsor’s
address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010
|
Signature of
Role |
Plan administrator |
Date |
2014-06-25 |
Name of individual signing |
YANITCIA GARCIA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LENSAR INC 401 K PROFIT SHARING PLAN TRUST
|
2012
|
320125724
|
2013-06-07
|
LENSAR INC
|
67
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
339110
|
Sponsor’s telephone number |
4075834241
|
Plan sponsor’s
address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010
|
Signature of
Role |
Plan administrator |
Date |
2013-06-07 |
Name of individual signing |
LENSAR INC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LENSAR INC 401 K PROFIT SHARING PLAN TRUST
|
2011
|
320125724
|
2012-06-01
|
LENSAR INC
|
46
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621510
|
Sponsor’s telephone number |
4075834241
|
Plan sponsor’s
address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010
|
Plan administrator’s name and address
Administrator’s EIN |
320125724 |
Plan administrator’s name |
LENSAR INC |
Plan administrator’s
address |
2800 DISCOVERY DR STE 100, ORLANDO, FL, 328263010 |
Administrator’s telephone number |
4075834241 |
Signature of
Role |
Plan administrator |
Date |
2012-06-01 |
Name of individual signing |
LENSAR INC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|