TRI-STATE PERIODONTICS, PSC PROFIT SHARING PLAN
|
2023
|
611299997
|
2024-10-01
|
TRI-STATE PERIODONTICS, PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE., SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2024-10-01 |
Name of individual signing |
GREGORY CRAFAT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI-STATE PERIODONTICS, PSC PROFIT SHARING PLAN
|
2022
|
611299997
|
2023-10-04
|
TRI-STATE PERIODONTICS, PSC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE., SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2023-10-04 |
Name of individual signing |
GREGORY CRAFAT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI STATE PERIODONTICS PSC PROFIT SHARING
|
2021
|
611299997
|
2022-10-05
|
TRI STATE PERIODONTICS PSC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2022-10-05 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-10-05 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI STATE PERIODONTICS PSC PROFIT SHARING
|
2020
|
611299997
|
2021-09-28
|
TRI STATE PERIODONTICS PSC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2021-09-28 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-09-28 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI STATE PERIODONTICS PSC PROFIT SHARING
|
2019
|
611299997
|
2020-10-05
|
TRI STATE PERIODONTICS PSC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2020-10-05 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-10-05 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI STATE PERIODONTICS PSC PROFIT SHARING
|
2018
|
611299997
|
2019-10-11
|
TRI STATE PERIODONTICS PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2019-10-11 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-10-11 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI STATE PERIODONTICS PSC PROFIT SHARING
|
2017
|
611299997
|
2018-09-26
|
TRI STATE PERIODONTICS PSC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2018-09-26 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-09-26 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI STATE PERIODONTICS PSC PROFIT SHARING
|
2016
|
611299997
|
2017-09-29
|
TRI STATE PERIODONTICS PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2017-09-29 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-09-29 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI STATE PERIODONTICS PSC PROFIT SHARING
|
2015
|
611299997
|
2016-10-17
|
TRI STATE PERIODONTICS PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2016-10-17 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-17 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI STATE PERIODONTICS PSC PROFIT SHARING
|
2014
|
611299997
|
2015-09-28
|
TRI STATE PERIODONTICS PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
6063246494
|
Plan sponsor’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101
|
Signature of
Role |
Plan administrator |
Date |
2015-09-28 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-09-28 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TRI STATE PERIODONTICS PSC PROFIT SHARING
|
2013
|
611299997
|
2014-10-08
|
TRI STATE PERIODONTICS PSC
|
4
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/08/20141008073111P030038390871001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2000-01-01 |
Business code |
621210 |
Sponsor’s telephone number |
6063246494 |
Plan sponsor’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101 |
Plan administrator’s name and address
Administrator’s EIN |
611299997 |
Plan administrator’s name |
TRI STATE PERIODONTICS PSC |
Plan administrator’s
address |
2154 CARTER AVE SUITE A, ASHLAND, KY, 41101 |
Signature of
Role |
Plan administrator |
Date |
2014-10-08 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-10-08 |
Name of individual signing |
GREGORY CRAFT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|