|
SHAFFER & SHAFFER FAMILY DENTISTRY P.S.C. 401(K) PLAN
|
2012
|
611230523
|
2013-08-16
|
SHAFFER & SHAFFER FAMILY DENTISTRY P.S.C.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1995-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6068368162
|
| Plan sponsor’s mailing address |
700 ST CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
| Plan sponsor’s
address |
700 ST CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
Plan administrator’s name and address
| Administrator’s EIN |
611230523 |
| Plan administrator’s name |
SHAFFER & SHAFFER FAMILY DENTISTRY P.S.C. |
| Plan administrator’s
address |
700 ST CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101 |
| Administrator’s telephone number |
6068368162 |
Number of participants as of the end of the plan year
| Active participants |
10 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
9 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2013-08-09 |
| Name of individual signing |
BARRY SHAFFER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SHAFFER & SHAFFER FAMILY DENTISTRY P.S.C. 401(K) PLAN
|
2011
|
611230523
|
2013-08-16
|
SHAFFER & SHAFFER FAMILY DENTISTRY P.S.C.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1995-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6068368162
|
| Plan sponsor’s mailing address |
700 ST CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
| Plan sponsor’s
address |
700 ST CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
Plan administrator’s name and address
| Administrator’s EIN |
611230523 |
| Plan administrator’s name |
SHAFFER & SHAFFER FAMILY DENTISTRY P.S.C. |
| Plan administrator’s
address |
700 ST CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101 |
| Administrator’s telephone number |
6068368162 |
Number of participants as of the end of the plan year
| Active participants |
10 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
9 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2013-08-09 |
| Name of individual signing |
BARRY SHAFFER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SHAFFER & SHAFFER FAMILY DENTISTRY P.S.C. 401(K) PLAN
|
2010
|
611230523
|
2011-06-16
|
SHAFFER & SHAFFER FAMILY DENTISTRY P.S.C.
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1995-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6068368162
|
| Plan sponsor’s mailing address |
700 ST CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
| Plan sponsor’s
address |
700 ST CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
Plan administrator’s name and address
| Administrator’s EIN |
611230523 |
| Plan administrator’s name |
SHAFFER & SHAFFER FAMILY DENTISTRY P.S.C. |
| Plan administrator’s
address |
700 ST CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101 |
| Administrator’s telephone number |
6068368162 |
Number of participants as of the end of the plan year
| Active participants |
11 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
10 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-06-13 |
| Name of individual signing |
BARRY SHAFFER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SHAFFER & SHAFFER FAMILY DENTISTRY, P.S.C.
|
2009
|
611230523
|
2010-04-27
|
SHAFFER & SHAFFER FAMILY DENTISTRY, P.S.C.
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1995-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6068268162
|
| Plan sponsor’s mailing address |
700 SAINT CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
| Plan sponsor’s
address |
700 SAINT CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
Plan administrator’s name and address
| Administrator’s EIN |
611230523 |
| Plan administrator’s name |
SHAFFER & SHAFFER FAMILY DENTISTRY, P.S.C. |
| Plan administrator’s
address |
700 SAINT CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101 |
| Administrator’s telephone number |
6068268162 |
Number of participants as of the end of the plan year
| Active participants |
11 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
8 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-04-27 |
| Name of individual signing |
BARRY SHAFFER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
