KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2023
|
591622468
|
2024-05-01
|
KILLINGSWORTH AGENCY, INC.
|
41
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
P.O. BOX 1750, BROOKSVILLE, FL, 346051750
|
Signature of
Role |
Plan administrator |
Date |
2024-05-01 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-05-01 |
Name of individual signing |
DIANNE WALDRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2022
|
591622468
|
2023-04-11
|
KILLINGSWORTH AGENCY, INC.
|
38
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
P.O. BOX 1750, BROOKSVILLE, FL, 346051750
|
Signature of
Role |
Plan administrator |
Date |
2023-04-11 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-04-11 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2021
|
591622468
|
2022-05-12
|
KILLINGSWORTH AGENCY, INC.
|
40
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
P.O. BOX 1750, BROOKSVILLE, FL, 346051750
|
Signature of
Role |
Plan administrator |
Date |
2022-05-12 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-05-12 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2020
|
591622468
|
2021-06-21
|
KILLINGSWORTH AGENCY, INC.
|
40
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
P.O. BOX 1750, BROOKSVILLE, FL, 346051750
|
Signature of
Role |
Plan administrator |
Date |
2021-06-21 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-06-21 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2019
|
591622468
|
2020-06-12
|
KILLINGSWORTH AGENCY, INC.
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
P.O. BOX 1750, BROOKSVILLE, FL, 346051750
|
Signature of
Role |
Plan administrator |
Date |
2020-06-12 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-06-12 |
Name of individual signing |
DIANNE WALDRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2018
|
591622468
|
2019-06-17
|
KILLINGSWORTH AGENCY, INC.
|
37
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
P.O. BOX 1750, BROOKSVILLE, FL, 346051750
|
Signature of
Role |
Plan administrator |
Date |
2019-06-17 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-17 |
Name of individual signing |
DIANNE WALDRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2017
|
591622468
|
2018-06-29
|
KILLINGSWORTH AGENCY, INC.
|
37
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
19259 CORTEZ BOULEVARD, BROOKSVILLE, FL, 346011750
|
Signature of
Role |
Plan administrator |
Date |
2018-06-29 |
Name of individual signing |
ELAINE DIRKSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2016
|
591622468
|
2017-07-20
|
KILLINGSWORTH AGENCY, INC.
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
19259 CORTEZ BOULEVARD, BROOKSVILLE, FL, 346011750
|
Signature of
Role |
Plan administrator |
Date |
2017-07-20 |
Name of individual signing |
DIANNE WALDRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-20 |
Name of individual signing |
DIANNE WALDRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2015
|
591622468
|
2016-05-27
|
KILLINGSWORTH AGENCY, INC.
|
37
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
19259 CORTEZ BOULEVARD, BROOKSVILLE, FL, 346011750
|
Signature of
Role |
Plan administrator |
Date |
2016-05-26 |
Name of individual signing |
DIANNE WALDRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-05-26 |
Name of individual signing |
DIANNE WALDRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KILLINGSWORTH AGENCY, INC. RETIREMENT PLAN
|
2014
|
591622468
|
2015-04-03
|
KILLINGSWORTH AGENCY, INC.
|
36
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2006-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
3527961451
|
Plan sponsor’s
address |
19259 CORTEZ BOULEVARD, BROOKSVILLE, FL, 34601
|
Signature of
Role |
Plan administrator |
Date |
2015-04-02 |
Name of individual signing |
DIANNE WALDRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-04-02 |
Name of individual signing |
DIANNE WALDRON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|