IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN
|
2013
|
571141668
|
2014-10-06
|
IMPLANT DENTISTRY OF VENICE, LLC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9414971585
|
Plan sponsor’s mailing address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
|
Plan sponsor’s
address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
|
Number of participants as of the end of the plan year
Active participants |
7 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
1 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
|
IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN
|
2012
|
571141668
|
2013-10-11
|
IMPLANT DENTISTRY OF VENICE, LLC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9414971585
|
Plan sponsor’s mailing address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
|
Plan sponsor’s
address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
|
Number of participants as of the end of the plan year
Active participants |
7 |
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 that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
Role |
Plan administrator |
Date |
2013-10-11 |
Name of individual signing |
DAVID M. CHAMPION |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-11 |
Name of individual signing |
DAVID M. CHAMPION |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN
|
2011
|
571141668
|
2012-10-12
|
IMPLANT DENTISTRY OF VENICE, LLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9414971585
|
Plan sponsor’s mailing address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
|
Plan sponsor’s
address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
|
Plan administrator’s name and address
Administrator’s EIN |
571141668 |
Plan administrator’s name |
IMPLANT DENTISTRY OF VENICE, LLC |
Plan administrator’s
address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285 |
Administrator’s telephone number |
9414971585 |
Number of participants as of the end of the plan year
Active participants |
8 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
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 |
2012-10-12 |
Name of individual signing |
DAVID M. CHAMPION |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-12 |
Name of individual signing |
DAVID M. CHAMPION |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN
|
2010
|
571141668
|
2011-10-03
|
IMPLANT DENTISTRY OF VENICE, LLC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9414971585
|
Plan sponsor’s mailing address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
|
Plan sponsor’s
address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
|
Plan administrator’s name and address
Administrator’s EIN |
571141668 |
Plan administrator’s name |
IMPLANT DENTISTRY OF VENICE, LLC |
Plan administrator’s
address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285 |
Administrator’s telephone number |
9414971585 |
Number of participants as of the end of the plan year
Active participants |
6 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
1 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
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 |
2011-10-03 |
Name of individual signing |
DAVID M. CHAMPION |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-10-03 |
Name of individual signing |
DAVID M. CHAMPION |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN AND TRUST
|
2009
|
571141668
|
2010-10-12
|
IMPLANT DENTISTRY OF VENICE, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9414971585
|
Plan sponsor’s
address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
|
Plan administrator’s name and address
Administrator’s EIN |
571141668 |
Plan administrator’s name |
IMPLANT DENTISTRY OF VENICE, LLC |
Plan administrator’s
address |
1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285 |
Administrator’s telephone number |
9414971585 |
Signature of
Role |
Plan administrator |
Date |
2010-10-12 |
Name of individual signing |
DAVID M. CHAMPION |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-12 |
Name of individual signing |
DAVID M. CHAMPION |
Valid signature |
Filed with authorized/valid electronic signature |
|
|