| Plan Name | BLACK HILLS UROLOGY GROUP PC 401 (K) PROFIT SHARING PLAN AND TRUST |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | BLACK HILLS UROLOGY GROUP PC |
| Employer identification number (EIN): | 262320325 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2013-01-01 | MICHAEL CAMPENNI | 2014-10-08 | MICHAEL CAMPENNI | 2014-10-08 |
| 001 | 2012-01-01 | MICHAEL CAMPENNI | 2014-10-08 | MICHAEL CAMPENNI | 2014-10-08 |
| 001 | 2011-01-01 | BLACK HILLS UROLOGY GROUP PC | 2012-07-30 | ||
| 001 | 2010-01-01 | BLACK HILLS UROLOGY GROUP PC | 2011-06-14 |