| Plan Name | DAVID J. DEGRAVE RETIREMENT SAVINGS PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | DAVID J. DEGRAVE, D.D.S., LTD. |
| Employer identification number (EIN): | 200632889 |
| NAIC Classification: | 621210 |
| NAIC Description: | Offices of Dentists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2011-01-01 | DAVID J. DEGRAVE, D.D.S. | 2012-09-10 | DAVID J. DEGRAVE, D.D.S. | 2012-09-10 |
| 001 | 2010-01-01 | DAVID J. DEGRAVE, D.D.S. | 2011-07-08 | DAVID J. DEGRAVE, D.D.S. | 2011-07-08 |