LUTHERAN CAMPUS ASC LLC 401(K) PROFIT SHARING PLAN & TRUST
|
2020
|
020749532
|
2021-07-21
|
LUTHERAN CAMPUS ASC LLC
|
34
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|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PKWY - STE 150, WHEAT RIDGE, CO, 80033
|
Signature of
Role |
Plan administrator |
Date |
2021-07-21 |
Name of individual signing |
HEIDI EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LUTHERAN CAMPUS ASC LLC 401(K) PROFIT SHARING PLAN & TRUST
|
2019
|
020749532
|
2020-04-17
|
LUTHERAN CAMPUS ASC LLC
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PKWY - STE 150, WHEAT RIDGE, CO, 80033
|
Signature of
Role |
Plan administrator |
Date |
2020-04-17 |
Name of individual signing |
SARA COLVARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LUTHERAN CAMPUS ASC LLC 401 K PROFIT SHARING PLAN TRUST
|
2018
|
020749532
|
2019-07-18
|
LUTHERAN CAMPUS ASC LLC
|
37
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PKWY - STE 150, WHEAT RIDGE, CO, 80033
|
Signature of
Role |
Plan administrator |
Date |
2019-07-18 |
Name of individual signing |
TOMMY HARVEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LUTHERAN ASC 401(K) PLAN
|
2017
|
020749532
|
2018-06-19
|
LUTHERAN CAMPUS ASC, LLC
|
27
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621493
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PARKWAY, SUITE 150, WHEAT RIDGE, CO, 81003
|
Signature of
Role |
Plan administrator |
Date |
2018-06-19 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-19 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LUTHERAN ASC 401(K) PLAN
|
2016
|
020749532
|
2017-07-28
|
LUTHERAN CAMPUS ASC, LLC
|
26
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621493
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PARKWAY, SUITE 150, WHEAT RIDGE, CO, 81003
|
Signature of
Role |
Plan administrator |
Date |
2017-07-28 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-28 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LUTHERAN ASC 401(K) PLAN
|
2015
|
020749532
|
2016-05-26
|
LUTHERAN CAMPUS ASC, LLC
|
31
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621493
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PARKWAY, SUITE 150, WHEAT RIDGE, CO, 81003
|
Signature of
Role |
Plan administrator |
Date |
2016-05-26 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-05-26 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LUTHERAN ASC 401(K) PLAN
|
2014
|
020749532
|
2015-06-19
|
LUTHERAN CAMPUS ASC, LLC
|
31
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621493
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PARKWAY, SUITE 150, WHEAT RIDGE, CO, 81003
|
Signature of
Role |
Plan administrator |
Date |
2015-06-19 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-06-19 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LUTHERAN ASC 401(K) PLAN
|
2013
|
020749532
|
2014-07-25
|
LUTHERAN CAMPUS ASC, LLC
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621493
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PARKWAY, SUITE 150, WHEAT RIDGE, CO, 81003
|
Signature of
Role |
Plan administrator |
Date |
2014-07-25 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-25 |
Name of individual signing |
DIANE LAMPRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LUTHERAN ASC 401(K) PLAN
|
2012
|
020749532
|
2013-06-19
|
LUTHERAN CAMPUS ASC, LLC
|
21
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621493
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PARKWAY, SUITE 150, WHEAT RIDGE, CO, 81003
|
Signature of
Role |
Plan administrator |
Date |
2013-06-19 |
Name of individual signing |
MOZIA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-19 |
Name of individual signing |
MOZIA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LUTHERAN ASC 401(K) PLAN
|
2011
|
020749532
|
2012-06-26
|
LUTHERAN CAMPUS ASC, LLC
|
21
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-07-01
|
Business code |
621493
|
Sponsor’s telephone number |
3033017700
|
Plan sponsor’s
address |
3455 LUTHERAN PARKWAY, SUITE 150, WHEAT RIDGE, CO, 81003
|
Plan administrator’s name and address
Administrator’s EIN |
020749532 |
Plan administrator’s name |
LUTHERAN CAMPUS ASC, LLC |
Plan administrator’s
address |
3455 LUTHERAN PARKWAY, SUITE 150, WHEAT RIDGE, CO, 81003 |
Administrator’s telephone number |
3033017700 |
Signature of
Role |
Plan administrator |
Date |
2012-06-26 |
Name of individual signing |
MOZIA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-06-26 |
Name of individual signing |
MOZIA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|