ARLENE R. BALUYUT, DMD 401(K) PROFIT SHARING PLAN
|
2017
|
204304558
|
2018-01-29
|
ARLENE R. BALUYUT, DMD, LLC
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5022261900
|
Plan
sponsor’s DBA name |
DBA DESIGNING SMILES
|
Plan sponsor’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2018-01-29 |
Name of individual signing |
NANCY CASSENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ARLENE R. BALUYUT, DMD 401(K) PROFIT SHARING PLAN
|
2016
|
204304558
|
2017-10-10
|
ARLENE R. BALUYUT, DMD, LLC
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5022261900
|
Plan
sponsor’s DBA name |
DBA DESIGNING SMILES
|
Plan sponsor’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2017-10-10 |
Name of individual signing |
TRACY MUNCY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ARLENE R. BALUYUT, DMD 401(K) PROFIT SHARING PLAN
|
2015
|
611101224
|
2016-10-12
|
ARLENE R. BALUYUT, DMD, LLC
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5022261900
|
Plan
sponsor’s DBA name |
DBA DESIGNING SMILES
|
Plan sponsor’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2016-10-12 |
Name of individual signing |
ARLENE BALUYUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ARLENE R. BALUYUT, DMD 401(K) PROFIT SHARING PLAN
|
2014
|
611101224
|
2015-10-02
|
ARLENE R. BALUYUT, DMD, LLC
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5022261900
|
Plan
sponsor’s DBA name |
DBA DESIGNING SMILES
|
Plan sponsor’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2015-10-02 |
Name of individual signing |
ARLENE BALUYUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ARLENE R. BALUYUT, DMD 401(K) PROFIT SHARING PLAN
|
2013
|
611101224
|
2014-09-29
|
ARLENE R. BALUYUT, DMD, LLC
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5022261900
|
Plan
sponsor’s DBA name |
DBA DESIGNING SMILES
|
Plan sponsor’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2014-09-29 |
Name of individual signing |
ARLENE BALUYUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ARLENE R. BALUYUT, DMD 401(K) PROFIT SHARING PLAN
|
2012
|
611101224
|
2013-07-15
|
ARLENE R. BALUYUT, DMD, LLC
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5022261900
|
Plan
sponsor’s DBA name |
DBA DESIGNING SMILES
|
Plan sponsor’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2013-07-15 |
Name of individual signing |
ARLENE BALUYUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ARLENE R. BALUYUT, DMD 401(K) PROFIT SHARING PLAN
|
2011
|
611101224
|
2012-07-09
|
ARLENE R. BALUYUT, DMD, LLC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5022261900
|
Plan
sponsor’s DBA name |
DBA DESIGNING SMILES
|
Plan sponsor’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601
|
Plan administrator’s name and address
Administrator’s EIN |
611101224 |
Plan administrator’s name |
ARLENE R. BALUYUT, DMD, LLC |
Plan administrator’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5022261900 |
Signature of
Role |
Plan administrator |
Date |
2012-07-09 |
Name of individual signing |
ARLENE BALUYUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ARLENE R. BALUYUT, DMD 401(K) PROFIT SHARING PLAN
|
2010
|
611101224
|
2011-09-28
|
ARLENE R. BALUYUT, DMD, LLC
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5022261900
|
Plan
sponsor’s DBA name |
DBA DESIGNING SMILES
|
Plan sponsor’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601
|
Plan administrator’s name and address
Administrator’s EIN |
611101224 |
Plan administrator’s name |
ARLENE R. BALUYUT, DMD, LLC |
Plan administrator’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5022261900 |
Signature of
Role |
Plan administrator |
Date |
2011-09-28 |
Name of individual signing |
ARLENE BALUYUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-09-28 |
Name of individual signing |
ARLENE BALUYUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ARLENE R. BALUYUT, DMD 401(K) PROFIT SHARING PLAN
|
2009
|
611101224
|
2010-09-29
|
ARLENE R. BALUYUT, DMD, LLC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5022261900
|
Plan
sponsor’s DBA name |
DBA DESIGNING SMILES
|
Plan sponsor’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601
|
Plan administrator’s name and address
Administrator’s EIN |
611101224 |
Plan administrator’s name |
ARLENE R. BALUYUT, DMD, LLC |
Plan administrator’s
address |
630 COMANCHE TRAIL, SUITE A, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5022261900 |
Signature of
Role |
Plan administrator |
Date |
2010-09-29 |
Name of individual signing |
ARLENE BALUYUT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|