NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2018
|
061025204
|
2019-06-12
|
NEW HAVEN DENTAL GROUP
|
41
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2019-06-12 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-12 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2018
|
061025204
|
2019-03-11
|
NEW HAVEN DENTAL GROUP
|
47
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2019-03-11 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-03-11 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2017
|
061025204
|
2018-08-27
|
NEW HAVEN DENTAL GROUP
|
44
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2018-08-27 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-08-27 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2016
|
061025204
|
2017-07-05
|
NEW HAVEN DENTAL GROUP
|
46
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2017-07-04 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-04 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2015
|
061025204
|
2016-08-08
|
NEW HAVEN DENTAL GROUP
|
38
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2016-08-08 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-08-08 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2014
|
061025204
|
2015-07-29
|
NEW HAVEN DENTAL GROUP
|
36
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2015-07-28 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-28 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2013
|
061025204
|
2014-08-20
|
NEW HAVEN DENTAL GROUP
|
38
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2014-08-20 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-08-20 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2012
|
061025204
|
2013-09-19
|
NEW HAVEN DENTAL GROUP
|
36
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2013-09-16 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-09-16 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2011
|
061025204
|
2012-09-25
|
NEW HAVEN DENTAL GROUP
|
35
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Plan administrator’s name and address
Administrator’s EIN |
061025204 |
Plan administrator’s name |
NEW HAVEN DENTAL GROUP |
Plan administrator’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511 |
Administrator’s telephone number |
2037818051 |
Signature of
Role |
Plan administrator |
Date |
2012-09-24 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-09-24 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NEW HAVEN DENTAL GROUP RETIREMENT PLAN
|
2010
|
061025204
|
2011-09-14
|
NEW HAVEN DENTAL GROUP
|
31
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
2037818051
|
Plan sponsor’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511
|
Plan administrator’s name and address
Administrator’s EIN |
061025204 |
Plan administrator’s name |
NEW HAVEN DENTAL GROUP |
Plan administrator’s
address |
123 YORK STREET, SUITE 4L, NEW HAVEN, CT, 06511 |
Administrator’s telephone number |
2037818051 |
Signature of
Role |
Plan administrator |
Date |
2011-09-13 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-09-13 |
Name of individual signing |
JOHN PLACHTYNA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|