|
CHARLES N. THEOBALD, D.D.S., P.C. PROFIT-SHARING PLAN
|
2013
|
840759674
|
2015-04-30
|
CHARLES N. THEOBALD, D.D.S., P.C.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-09-30
|
| Business code |
621210
|
| Sponsor’s telephone number |
3037910413
|
| Plan sponsor’s
address |
200 WEST COUNTY LINE RD., SUITE 210, HIGHLANDS RANCH, CO, 80129
|
Signature of
| Role |
Plan administrator |
| Date |
2015-04-30 |
| Name of individual signing |
CHARLES N. THEOBALD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2015-04-30 |
| Name of individual signing |
CHARLES N. THEOBALD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHARLES N. THEOBALD, D.D.S., P.C. PROFIT-SHARING PLAN
|
2012
|
840759674
|
2014-07-10
|
CHARLES N. THEOBALD, D.D.S., P.C.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-09-30
|
| Business code |
621210
|
| Sponsor’s telephone number |
3037910413
|
| Plan sponsor’s
address |
200 WEST COUNTY LINE RD., SUITE 210, HIGHLANDS RANCH, CO, 80129
|
Signature of
| Role |
Plan administrator |
| Date |
2014-07-10 |
| Name of individual signing |
CHARLES N. THEOBALD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2014-07-10 |
| Name of individual signing |
CHARLES N. THEOBALD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHARLES N. THEOBALD, D.D.S., P.C. PROFIT-SHARING PLAN
|
2011
|
840759674
|
2013-07-15
|
CHARLES N. THEOBALD, D.D.S., P.C.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1982-09-30
|
| Business code |
621210
|
| Sponsor’s telephone number |
3037910413
|
| Plan sponsor’s
address |
200 WEST COUNTY LINE RD., SUITE 210, HIGHLANDS RANCH, CO, 80129
|
Plan administrator’s name and address
| Administrator’s EIN |
840759674 |
| Plan administrator’s name |
CHARLES N. THEOBALD, D.D.S., P.C. |
| Plan administrator’s
address |
200 WEST COUNTY LINE RD., SUITE 210, HIGHLANDS RANCH, CO, 80129 |
| Administrator’s telephone number |
3037910413 |
Signature of
| Role |
Plan administrator |
| Date |
2013-07-15 |
| Name of individual signing |
CHARLES N. THEOBALD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-07-15 |
| Name of individual signing |
CHARLES N. THEOBALD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHARLES N. THEOBALD, D.D.S., P.C. PROFIT-SHARING PLAN
|
2010
|
840759674
|
2012-12-20
|
CHARLES N. THEOBALD, D.D.S., P.C.
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1978-10-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3037910413
|
| Plan sponsor’s
address |
200 W. COUNTY LINE RD., #210, HIGHLANDS RANCH, CO, 801262342
|
Plan administrator’s name and address
| Administrator’s EIN |
840759674 |
| Plan administrator’s name |
CHARLES N. THEOBALD, D.D.S., P.C. |
| Plan administrator’s
address |
200 W. COUNTY LINE RD., #210, HIGHLANDS RANCH, CO, 801262342 |
| Administrator’s telephone number |
3037910413 |
Signature of
| Role |
Plan administrator |
| Date |
2012-12-20 |
| Name of individual signing |
CHARLES N. THEOBALD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-12-20 |
| Name of individual signing |
CHARLES N. THEOBALD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
