HERITAGE DENTAL 401(K) PLAN
|
2023
|
363869109
|
2024-10-15
|
HERITAGE DENTAL
|
20
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2015-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473951461
|
Plan sponsor’s
address |
800 N MAIN STREET, ANTIOCH, IL, 60002
|
|
HERITAGE DENTAL 401(K) PLAN
|
2022
|
363869109
|
2023-09-21
|
HERITAGE DENTAL
|
19
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2015-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473951461
|
Plan sponsor’s
address |
800 N MAIN STREET, ANTIOCH, IL, 60002
|
Signature of
Role |
Plan administrator |
Date |
2023-09-21 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-21 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERITAGE DENTAL 401(K) PLAN
|
2021
|
363869109
|
2022-06-29
|
HERITAGE DENTAL
|
20
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2015-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473951461
|
Plan sponsor’s
address |
800 N MAIN STREET, ANTIOCH, IL, 60002
|
Signature of
Role |
Plan administrator |
Date |
2022-06-29 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-06-29 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERITAGE DENTAL 401(K) PLAN
|
2020
|
363869109
|
2021-04-29
|
HERITAGE DENTAL
|
19
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2015-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473951461
|
Plan sponsor’s
address |
800 N MAIN STREET, ANTIOCH, IL, 60002
|
Signature of
Role |
Plan administrator |
Date |
2021-04-29 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-04-29 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERITAGE DENTAL 401(K) PLAN
|
2019
|
363869109
|
2020-05-19
|
HERITAGE DENTAL
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2015-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473951461
|
Plan sponsor’s
address |
800 N MAIN STREET, ANTIOCH, IL, 60002
|
Signature of
Role |
Plan administrator |
Date |
2020-05-19 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-05-19 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERITAGE DENTAL 401(K) PLAN
|
2018
|
363869109
|
2019-05-22
|
HERITAGE DENTAL
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2015-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473951461
|
Plan sponsor’s
address |
800 N MAIN STREET, ANTIOCH, IL, 60002
|
Signature of
Role |
Plan administrator |
Date |
2019-05-22 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-05-22 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERITAGE DENTAL 401(K) PLAN
|
2017
|
363869109
|
2018-05-24
|
HERITAGE DENTAL
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2015-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473951461
|
Plan sponsor’s
address |
800 N MAIN STREET, ANTIOCH, IL, 60002
|
Signature of
Role |
Plan administrator |
Date |
2018-05-24 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-24 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERITAGE DENTAL 401(K) PLAN
|
2016
|
363869109
|
2017-06-13
|
HERITAGE DENTAL
|
18
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2015-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473951461
|
Plan sponsor’s
address |
800 N MAIN STREET, ANTIOCH, IL, 60002
|
Signature of
Role |
Plan administrator |
Date |
2017-06-13 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-13 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERITAGE DENTAL 401(K) PLAN
|
2015
|
363869109
|
2016-06-21
|
HERITAGE DENTAL
|
19
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2015-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473951461
|
Plan sponsor’s
address |
800 N MAIN STREET, ANTIOCH, IL, 60002
|
Signature of
Role |
Plan administrator |
Date |
2016-06-21 |
Name of individual signing |
KENNETH JAZDZEWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|