DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2017
|
261645779
|
2018-06-23
|
DAVID W. BERRY DMD, LLC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Signature of
Role |
Plan administrator |
Date |
2018-06-23 |
Name of individual signing |
DAVID BERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W BERRY DMD, LLC PROFIT SHARING PLAN
|
2017
|
261645779
|
2018-10-20
|
DAVID W BERRY DMD, LLC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Signature of
Role |
Plan administrator |
Date |
2018-10-20 |
Name of individual signing |
DAVID BERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2016
|
261645779
|
2017-06-27
|
DAVID W. BERRY DMD, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Signature of
Role |
Plan administrator |
Date |
2017-06-27 |
Name of individual signing |
DAVID BERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2015
|
261645779
|
2016-06-19
|
DAVID W. BERRY DMD, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Signature of
Role |
Plan administrator |
Date |
2016-06-19 |
Name of individual signing |
DAVID BERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2014
|
261645779
|
2015-03-24
|
DAVID W BERRY DMD, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Signature of
Role |
Plan administrator |
Date |
2015-03-24 |
Name of individual signing |
DAVID W. BERRY, D.M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-03-24 |
Name of individual signing |
DAVID W. BERRY, D.M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2013
|
261645779
|
2014-03-25
|
DAVID W BERRY DMD, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Signature of
Role |
Plan administrator |
Date |
2014-03-25 |
Name of individual signing |
DAVID W BERRY, DMD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-03-25 |
Name of individual signing |
DAVID W BERRY, DMD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2012
|
261645779
|
2013-05-08
|
DAVID W BERRY DMD, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Signature of
Role |
Plan administrator |
Date |
2013-05-08 |
Name of individual signing |
DAVID W. BERRY, DMD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-05-08 |
Name of individual signing |
DAVID W. BERRY, DMD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2011
|
261645779
|
2012-05-04
|
DAVID W BERRY DMD, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Plan administrator’s name and address
Administrator’s EIN |
261645779 |
Plan administrator’s name |
SAME |
Plan administrator’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051 |
Administrator’s telephone number |
8593717000 |
Signature of
Role |
Plan administrator |
Date |
2012-05-04 |
Name of individual signing |
DAVID W. BERRY, DMD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-05-04 |
Name of individual signing |
DAVID W. BERRY, DMD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2010
|
261645779
|
2011-04-27
|
DAVID W BERRY DMD, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Plan administrator’s name and address
Administrator’s EIN |
261645779 |
Plan administrator’s name |
SAME |
Plan administrator’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051 |
Administrator’s telephone number |
8593717000 |
Signature of
Role |
Plan administrator |
Date |
2011-04-27 |
Name of individual signing |
DAVID W. BERRY, D.M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-04-27 |
Name of individual signing |
DAVID W. BERRY, D.M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2009
|
261645779
|
2010-05-17
|
DAVID W BERRY DMD, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8593717000
|
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051
|
Plan administrator’s name and address
Administrator’s EIN |
261645779 |
Plan administrator’s name |
SAME |
Plan administrator’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051 |
Administrator’s telephone number |
8593717000 |
Signature of
Role |
Plan administrator |
Date |
2010-05-17 |
Name of individual signing |
DAVID W. BERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-05-17 |
Name of individual signing |
DAVID W. BERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DAVID W. BERRY DMD, LLC PROFIT SHARING PLAN
|
2009
|
261645779
|
2010-05-17
|
DAVID W BERRY DMD, LLC
|
4
|
|
Three-digit plan number (PN) |
001 |
Effective date of plan |
1993-01-01 |
Business code |
621210 |
Sponsor’s telephone number |
8593717000 |
Plan sponsor’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051 |
Plan administrator’s name and address
Administrator’s EIN |
261645779 |
Plan administrator’s name |
SAME |
Plan administrator’s
address |
4205 RICHARDSON RD, INDEPENDENCE, KY, 41051 |
Administrator’s telephone number |
8593717000 |
Signature of
Role |
Plan administrator |
Date |
2010-05-17 |
Name of individual signing |
DAVID W. BERRY, D.M.D. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-05-17 |
Name of individual signing |
DAVID W. BERRY, D.M.D. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|