ORTHOPEDIC & SPORT REHABILITATION RETIREMENT PLAN
|
2018
|
201878662
|
2019-09-13
|
ORTHOPEDIC & SPORT REHABILITATION,
|
53
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-10-01
|
Business code |
621111
|
Plan sponsor’s
address |
7872 CENTURY BLVD, CHANHASSEN, MN, 55317
|
Signature of
Role |
Plan administrator |
Date |
2019-09-13 |
Name of individual signing |
ZACHARY P GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-09-13 |
Name of individual signing |
ZACHARY P GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ORTHOPEDIC & SPORT REHABILITATION RETIREMENT PLAN
|
2018
|
201878662
|
2019-07-08
|
ORTHOPEDIC & SPORT REHABILITATION, LLC
|
53
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
9524489081
|
Plan sponsor’s
address |
7872 CENTURY BLVD, CHANHASSEN, MN, 55317
|
Signature of
Role |
Plan administrator |
Date |
2019-07-08 |
Name of individual signing |
ZACHARY GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-07-08 |
Name of individual signing |
ZACHARY GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ORTHOPEDIC & SPORT REHABILITATION RETIREMENT PLAN
|
2017
|
201878662
|
2018-06-21
|
ORTHOPEDIC & SPORT REHABILITATION, LLC
|
50
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
9524489081
|
Plan sponsor’s
address |
7872 CENTURY BLVD, CHANHASSEN, MN, 55317
|
Signature of
Role |
Plan administrator |
Date |
2018-06-21 |
Name of individual signing |
ZACHARY P. GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-21 |
Name of individual signing |
ZACHARY P. GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ORTHOPEDIC & SPORT REHABILITATION RETIREMENT PLAN
|
2016
|
201878662
|
2017-06-16
|
ORTHOPEDIC & SPORT REHABILITATION, LLC
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
9524489081
|
Plan sponsor’s
address |
7872 CENTURY BLVD, CHANHASSEN, MN, 55317
|
Signature of
Role |
Plan administrator |
Date |
2017-06-16 |
Name of individual signing |
ZACHARY P. GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-16 |
Name of individual signing |
ZACHARY P. GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ORTHOPEDIC & SPORT REHABILITATION RETIREMENT PLAN
|
2015
|
201878662
|
2016-10-07
|
ORTHOPEDIC & SPORT REHABILITATION, LLC
|
28
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
9524489081
|
Plan sponsor’s
address |
7872 CENTURY BLVD, CHANHASSEN, MN, 55317
|
Signature of
Role |
Plan administrator |
Date |
2016-10-07 |
Name of individual signing |
ZACHARY P. GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-07 |
Name of individual signing |
ZACHARY P. GIEBLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ORTHOPEDIC & SPORT REHABILITATION RETIREMENT PLAN
|
2010
|
201878662
|
2011-03-18
|
ORTHOPEDIC & SPORT REHABILITATION, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-10-01
|
Business code |
621340
|
Sponsor’s telephone number |
9524489081
|
Plan sponsor’s mailing address |
7872 CENTURY BLVD, CHANHASSEN, MN, 55317
|
Plan sponsor’s
address |
7872 CENTURY BLVD, CHANHASSEN, MN, 55317
|
Plan administrator’s name and address
Administrator’s EIN |
201878662 |
Plan administrator’s name |
ORTHOPEDIC & SPORT REHABILITATION, LLC |
Plan administrator’s
address |
7872 CENTURY BLVD, CHANHASSEN, MN, 55317 |
Administrator’s telephone number |
9524489081 |
Number of participants as of the end of the plan year
Active participants |
7 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-03-18 |
Name of individual signing |
NATHAN STIER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|