PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2019
|
061050087
|
2020-01-13
|
PETER B. NELSON, D.D.S., P.C.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Signature of
Role |
Plan administrator |
Date |
2020-01-13 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2018
|
061050087
|
2019-03-26
|
PETER B. NELSON, D.D.S., P.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Signature of
Role |
Plan administrator |
Date |
2019-03-26 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2017
|
061050087
|
2018-02-21
|
PETER B. NELSON, D.D.S., P.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Signature of
Role |
Plan administrator |
Date |
2018-02-21 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2017
|
061050087
|
2018-02-16
|
PETER B. NELSON, D.D.S., P.C.
|
8
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Signature of
Role |
Plan administrator |
Date |
2018-02-16 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2016
|
061050087
|
2017-03-10
|
PETER B. NELSON, D.D.S., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Signature of
Role |
Plan administrator |
Date |
2017-03-10 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2015
|
061050087
|
2016-03-11
|
PETER B. NELSON, D.D.S., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Signature of
Role |
Plan administrator |
Date |
2016-03-11 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2014
|
061050087
|
2015-02-18
|
PETER B. NELSON, D.D.S., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Signature of
Role |
Plan administrator |
Date |
2015-02-18 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2013
|
061050087
|
2014-04-11
|
PETER B. NELSON, D.D.S., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Signature of
Role |
Plan administrator |
Date |
2014-04-11 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2012
|
061050087
|
2013-03-15
|
PETER B. NELSON, D.D.S., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Signature of
Role |
Plan administrator |
Date |
2013-03-15 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER B. NELSON, D.D.S., P.C. RETIREMENT PLAN
|
2011
|
061050087
|
2012-03-21
|
PETER B. NELSON, D.D.S., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-11-01
|
Business code |
621210
|
Sponsor’s telephone number |
8603471227
|
Plan sponsor’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457
|
Plan administrator’s name and address
Administrator’s EIN |
061050087 |
Plan administrator’s name |
PETER B. NELSON, D.D.S., P.C. |
Plan administrator’s
address |
717 NEWFIELD ST, MIDDLETOWN, CT, 06457 |
Administrator’s telephone number |
8603471227 |
Signature of
Role |
Plan administrator |
Date |
2012-03-21 |
Name of individual signing |
PETER B. NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|