SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN
|
2020
|
141798157
|
2021-10-13
|
SPA DENTAL, P.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
|
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN
|
2019
|
141798157
|
2020-10-07
|
SPA DENTAL, P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
|
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN
|
2018
|
141798157
|
2019-07-30
|
SPA DENTAL, P.C.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
|
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN
|
2017
|
141798157
|
2018-09-28
|
SPA DENTAL, P.C.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
|
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN
|
2016
|
141798157
|
2017-10-10
|
SPA DENTAL, P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
|
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2014
|
141798157
|
2015-07-14
|
SPA DENTAL, P.C.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
|
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2013
|
141798157
|
2014-08-11
|
SPA DENTAL, P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
|
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2012
|
141798157
|
2013-05-15
|
SPA DENTAL, P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
Signature of
Role |
Plan administrator |
Date |
2013-05-15 |
Name of individual signing |
JAMES HANSEN, DMD |
|
Role |
Employer/plan sponsor |
Date |
2013-05-15 |
Name of individual signing |
JAMES HANSEN, DMD |
|
|
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2011
|
141798157
|
2012-05-11
|
SPA DENTAL, P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
Plan administrator’s name and address
Administrator’s EIN |
141798157 |
Plan administrator’s name |
SPA DENTAL, P.C. |
Plan administrator’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020 |
Administrator’s telephone number |
5188851791 |
Signature of
Role |
Plan administrator |
Date |
2012-05-10 |
Name of individual signing |
SUSAN HANSEN |
|
Role |
Employer/plan sponsor |
Date |
2012-05-10 |
Name of individual signing |
SUSAN HANSEN |
|
|
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2010
|
141798157
|
2011-06-02
|
SPA DENTAL, P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5188851791
|
Plan sponsor’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020
|
Plan administrator’s name and address
Administrator’s EIN |
141798157 |
Plan administrator’s name |
SPA DENTAL, P.C. |
Plan administrator’s
address |
68 MILTON AVENUE, BALLSTON SPA, NY, 12020 |
Administrator’s telephone number |
5188851791 |
Signature of
Role |
Plan administrator |
Date |
2011-06-01 |
Name of individual signing |
JAMES T. HANSEN DMD |
|
Role |
Employer/plan sponsor |
Date |
2011-06-01 |
Name of individual signing |
JAMES T. HANSEN DMD |
|
|