MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2019
|
593257669
|
2021-01-15
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2021-01-15 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2018
|
593257669
|
2019-10-02
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2019-10-02 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2017
|
593257669
|
2018-10-15
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2018-10-15 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2016
|
593257669
|
2017-08-22
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2017-08-22 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2015
|
593257669
|
2016-10-04
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2016-10-04 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-04 |
Name of individual signing |
MICHAEL D. LITVAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2014
|
593257669
|
2015-10-15
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2015-10-15 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-15 |
Name of individual signing |
MICHAEL D. LITVAK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2013
|
593257669
|
2015-10-15
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2015-10-15 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-15 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2013
|
593257669
|
2014-10-15
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
10
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2012
|
593257669
|
2013-10-14
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2013-10-14 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL D. LITVAK, D.D.S., P.A. RETIREMENT PLAN
|
2011
|
593257669
|
2012-10-16
|
MICHAEL D. LITVAK, D.D.S., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8504771010
|
Plan sponsor’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504
|
Plan administrator’s name and address
Administrator’s EIN |
593257669 |
Plan administrator’s name |
MICHAEL D. LITVAK, D.D.S., P.A. |
Plan administrator’s
address |
6105 NORTH DAVIS HIGHWAY, UNIT B, PENSACOLA, FL, 32504 |
Administrator’s telephone number |
8504771010 |
Signature of
Role |
Plan administrator |
Date |
2012-10-15 |
Name of individual signing |
MICHAEL D. LITVAK, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|