THE SUMMIT DENTAL GROUP, P.C. 401(K) PROFIT SHARING PLAN & TRUST
|
2013
|
161005426
|
2015-01-27
|
THE SUMMIT DENTAL GROUP, P.C.
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1994-09-01
|
Business code |
621210
|
Sponsor’s telephone number |
3154570620
|
Plan sponsor’s
address |
7555 MORGAN ROAD, LIVERPOOL, NY, 130892645
|
Signature of
Role |
Plan administrator |
Date |
2015-01-27 |
Name of individual signing |
ROBERT F. CLARK, D.D.S. |
|
|
THE SUMMIT DENTAL GROUP, P.C. 401(K) PROFIT SHARING PLAN & TRUST
|
2012
|
161005426
|
2013-12-24
|
THE SUMMIT DENTAL GROUP, P.C.
|
27
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1994-09-01
|
Business code |
621210
|
Sponsor’s telephone number |
3154570620
|
Plan sponsor’s
address |
7555 MORGAN ROAD, LIVERPOOL, NY, 130892645
|
Signature of
Role |
Plan administrator |
Date |
2013-12-24 |
Name of individual signing |
ROBERT F. CLARK, D.D.S. |
|
|
THE SUMMIT DENTAL GROUP, P.C. 401(K) PROFIT SHARING PLAN & TRUST
|
2011
|
161005426
|
2012-10-29
|
THE SUMMIT DENTAL GROUP, P.C.
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1994-09-01
|
Business code |
621210
|
Sponsor’s telephone number |
3154570620
|
Plan sponsor’s
address |
7555 MORGAN ROAD, LIVERPOOL, NY, 130892645
|
Plan administrator’s name and address
Administrator’s EIN |
161005426 |
Plan administrator’s name |
THE SUMMIT DENTAL GROUP, P.C. |
Plan administrator’s
address |
7555 MORGAN ROAD, LIVERPOOL, NY, 130892645 |
Administrator’s telephone number |
3154570620 |
Signature of
Role |
Plan administrator |
Date |
2012-10-29 |
Name of individual signing |
ROBERT F. CLARK, D.D.S. |
|
|
THE SUMMIT DENTAL GROUP, P.C. 401(K) PROFIT SHARING PLAN & TRUST
|
2010
|
161005426
|
2011-12-05
|
THE SUMMIT DENTAL GROUP, P.C.
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1994-09-01
|
Business code |
621210
|
Sponsor’s telephone number |
3154570620
|
Plan sponsor’s
address |
7555 MORGAN ROAD, LIVERPOOL, NY, 130892645
|
Plan administrator’s name and address
Administrator’s EIN |
161005426 |
Plan administrator’s name |
THE SUMMIT DENTAL GROUP, P.C. |
Plan administrator’s
address |
7555 MORGAN ROAD, LIVERPOOL, NY, 130892645 |
Administrator’s telephone number |
3154570620 |
Signature of
Role |
Plan administrator |
Date |
2011-12-05 |
Name of individual signing |
ROBERT F. CLARK, D.D.S. |
|
Role |
Employer/plan sponsor |
Date |
2011-12-05 |
Name of individual signing |
ROBERT F. CLARK, D.D.S. |
|
|
THE SUMMIT DENTAL GROUP, P.C. 401(K) PROFIT SHARING PLAN & TRUST
|
2009
|
161005426
|
2011-05-11
|
THE SUMMIT DENTAL GROUP, P.C.
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1994-09-01
|
Business code |
621210
|
Sponsor’s telephone number |
3154570620
|
Plan sponsor’s
address |
7555 MORGAN ROAD, LIVERPOOL, NY, 130892645
|
Plan administrator’s name and address
Administrator’s EIN |
161005426 |
Plan administrator’s name |
THE SUMMIT DENTAL GROUP, P.C. |
Plan administrator’s
address |
7555 MORGAN ROAD, LIVERPOOL, NY, 130892645 |
Administrator’s telephone number |
3154570620 |
Signature of
Role |
Plan administrator |
Date |
2011-05-11 |
Name of individual signing |
ROBERT F. CLARK, D.D.S. |
|
|