|
MODERN KIDS DENTISTRY CBS BENEFIT PLAN
|
2023
|
472668506
|
2024-12-30
|
MODERN KIDS DENTISTRY
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2023-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
5024101710
|
| Plan sponsor’s
address |
130 N EVERGREEN RD, UNIT 100, LOUISVILLE, KY, 40243
|
Plan administrator’s name and address
| Administrator’s EIN |
846429706 |
| Plan administrator’s name |
JOSEPH HSU |
| Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number |
5026954700 |
Signature of
| Role |
Plan administrator |
| Date |
2024-12-30 |
| Name of individual signing |
JOSEPH HSU |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN KIDS DENTISTRY 401K PLAN
|
2023
|
472668506
|
2024-07-09
|
MODERN KIDS DENTISTRY
|
25
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8596081579
|
| Plan sponsor’s
address |
129 EVERGREEN RD, LOUISVILLE, KY, 40243
|
Signature of
| Role |
Plan administrator |
| Date |
2024-07-09 |
| Name of individual signing |
ARNESSA RAYBOULD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN KIDS DENTISTRY 401K PLAN
|
2022
|
472668506
|
2023-06-28
|
MODERN KIDS DENTISTRY
|
21
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8596081579
|
| Plan sponsor’s
address |
129 EVERGREEN RD, LOUISVILLE, KY, 40243
|
Signature of
| Role |
Plan administrator |
| Date |
2023-06-28 |
| Name of individual signing |
ARNESSA CRAFT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN KIDS DENTISTRY CBS BENEFIT PLAN
|
2022
|
472668506
|
2023-12-27
|
MODERN KIDS DENTISTRY
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2023-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
5024101710
|
| Plan sponsor’s
address |
130 N EVERGREEN RD, UNIT 100, LOUISVILLE, KY, 40243
|
Plan administrator’s name and address
| Administrator’s EIN |
846429706 |
| Plan administrator’s name |
SHAWNA BURTON |
| Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number |
5026954700 |
Signature of
| Role |
Plan administrator |
| Date |
2023-12-27 |
| Name of individual signing |
SHAWNA BURTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN KIDS DENTISTRY 401K PLAN
|
2021
|
472668506
|
2022-07-18
|
MODERN KIDS DENTISTRY
|
20
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8596081579
|
| Plan sponsor’s
address |
129 EVERGREEN RD, LOUISVILLE, KY, 40243
|
Signature of
| Role |
Plan administrator |
| Date |
2022-07-18 |
| Name of individual signing |
ARNESSA CRAFT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN KIDS DENTISTRY 401K PLAN
|
2020
|
472668506
|
2021-05-25
|
MODERN KIDS DENTISTRY
|
18
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8596081579
|
| Plan sponsor’s
address |
129 EVERGREEN RD, LOUISVILLE, KY, 40243
|
Signature of
| Role |
Plan administrator |
| Date |
2021-05-25 |
| Name of individual signing |
ARNESSA CRAFT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2021-05-25 |
| Name of individual signing |
ARNESSA CRAFT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
