|
OLDSMAR DENTAL, PLLC 401(K) PROFIT SHARING PLAN & TRUST
|
2023
|
811376799
|
2024-06-07
|
OLDSMAR DENTAL, PLLC
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
541990
|
| Sponsor’s telephone number |
8137679503
|
| Plan sponsor’s
address |
4050 TAMPA ROAD, OLDSMAR, FL, 34677
|
Signature of
| Role |
Plan administrator |
| Date |
2024-06-07 |
| Name of individual signing |
DANA DAVIDSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
OLDSMAR DENTAL, PLLC 401(K) PROFIT SHARING PLAN & TRUST
|
2022
|
811376799
|
2024-02-26
|
OLDSMAR DENTAL, PLLC
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
541990
|
| Sponsor’s telephone number |
8137679503
|
| Plan sponsor’s
address |
4050 TAMPA ROAD, OLDSMAR, FL, 34677
|
Signature of
| Role |
Plan administrator |
| Date |
2024-02-26 |
| Name of individual signing |
DANA DAVIDSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
OLDSMAR DENTAL PLLC 401(K) PROFIT SHARING PLAN & TRUST
|
2021
|
811376799
|
2022-05-04
|
OLDSMAR DENTAL PLLC
|
13
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
541990
|
| Sponsor’s telephone number |
8137679503
|
| Plan sponsor’s
address |
4050 TAMPA RD., OLDSMAR, FL, 34677
|
Signature of
| Role |
Plan administrator |
| Date |
2022-05-04 |
| Name of individual signing |
LORI BURCHELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
OLDSMAR DENTAL PLLC 401(K) PROFIT SHARING PLAN & TRUST
|
2020
|
811376799
|
2021-06-22
|
OLDSMAR DENTAL PLLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
541990
|
| Sponsor’s telephone number |
8137679503
|
| Plan sponsor’s
address |
4050 TAMPA RD., OLDSMAR, FL, 34677
|
Signature of
| Role |
Plan administrator |
| Date |
2021-06-22 |
| Name of individual signing |
LORI BURCHELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
OLDSMAR DENTAL PLLC 401(K) PROFIT SHARING PLAN & TRUST
|
2019
|
811376799
|
2020-05-12
|
OLDSMAR DENTAL PLLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
541990
|
| Sponsor’s telephone number |
8137679503
|
| Plan sponsor’s
address |
4050 TAMPA RD., OLDSMAR, FL, 34677
|
Signature of
| Role |
Plan administrator |
| Date |
2020-05-12 |
| Name of individual signing |
LORI BURCHELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
