|
POUDRE VALLEY PERIODONTICS 401(K) PLAN
|
2023
|
824675749
|
2024-06-04
|
POUDRE VALLEY PERIODONTICS & DENTAL IMPLANTS
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9704473746
|
| Plan sponsor’s
address |
1221 E ELIZABETH STREET, SUITE 1, FORT COLLINS, CO, 80524
|
Signature of
| Role |
Plan administrator |
| Date |
2024-06-04 |
| Name of individual signing |
VALERIE JOHNSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
POUDRE VALLEY PERIODONTICS 401(K) PLAN
|
2022
|
824675749
|
2023-06-30
|
POUDRE VALLEY PERIODONTICS & DENTAL IMPLANTS
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9704473746
|
| Plan sponsor’s
address |
1221 E ELIZABETH STREET, SUITE 1, FORT COLLINS, CO, 80524
|
Signature of
| Role |
Plan administrator |
| Date |
2023-06-30 |
| Name of individual signing |
VALERIE JOHNSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
POUDRE VALLEY PERIODONTICS 401(K) PLAN
|
2021
|
824675749
|
2022-07-29
|
POUDRE VALLEY PERIODONTICS & DENTAL IMPLANTS
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9704473746
|
| Plan sponsor’s
address |
1221 E ELIZABETH STREET, SUITE 1, FORT COLLINS, CO, 80524
|
Signature of
| Role |
Plan administrator |
| Date |
2022-07-29 |
| Name of individual signing |
VALERIE JOHNSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
POUDRE VALLEY PERIODONTICS 401(K) PLAN
|
2020
|
824675749
|
2021-09-30
|
POUDRE VALLEY PERIODONTICS & DENTAL IMPLANTS
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9704473746
|
| Plan sponsor’s
address |
1221 E ELIZABETH STREET, STE. 1, FORT COLLINS, CO, 80524
|
Signature of
| Role |
Plan administrator |
| Date |
2021-09-30 |
| Name of individual signing |
VALERIE JOHNSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
POUDRE VALLEY PERIODONTICS 401(K) PLAN
|
2019
|
824675749
|
2020-10-14
|
POUDRE VALLEY PERIODONTICS & DENTAL IMPLANTS
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9704473746
|
| Plan sponsor’s
address |
1221 E ELIZABETH STREET, STE. 1, FORT COLLINS, CO, 80524
|
Signature of
| Role |
Plan administrator |
| Date |
2020-10-14 |
| Name of individual signing |
VALERIE JOHNSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
