JAFFE EYE INSTITUTE P.A. 401K PROFIT SHARING PLAN
|
2010
|
591204805
|
2011-09-15
|
JAFFE EYE INSTITUTE P.A.
|
26
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2011-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
3059457433
|
Plan sponsor’s mailing address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180
|
Plan sponsor’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180
|
Plan administrator’s name and address
Administrator’s EIN |
591204805 |
Plan administrator’s name |
JAFFE EYE INSTITUTE P.A. |
Plan administrator’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180 |
Administrator’s telephone number |
3059457433 |
Number of participants as of the end of the plan year
Active participants |
0 |
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 |
2011-09-15 |
Name of individual signing |
EMERY JAFFE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAFFE EYE INSTITUTE P.A. 401K PROFIT SHARING PLAN
|
2010
|
591204805
|
2011-09-15
|
JAFFE EYE INSTITUTE P.A.
|
26
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2011-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
3059457433
|
Plan sponsor’s mailing address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180
|
Plan sponsor’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180
|
Plan administrator’s name and address
Administrator’s EIN |
591204805 |
Plan administrator’s name |
JAFFE EYE INSTITUTE P.A. |
Plan administrator’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180 |
Administrator’s telephone number |
3059457433 |
Number of participants as of the end of the plan year
Active participants |
0 |
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 |
2011-09-15 |
Name of individual signing |
EMERY JAFFE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAFFE EYE INSTITUTE PA 401 K PROFIT SHARING PLAN TRUST
|
2010
|
591204805
|
2011-05-18
|
JAFFE EYE INSTITUTE, P.A.
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3059457433
|
Plan sponsor’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180
|
Plan administrator’s name and address
Administrator’s EIN |
591204805 |
Plan administrator’s name |
JAFFE EYE INSTITUTE, P.A. |
Plan administrator’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180 |
Administrator’s telephone number |
3059457433 |
Signature of
Role |
Plan administrator |
Date |
2011-05-18 |
Name of individual signing |
JAFFE EYE INSTITUTE, P.A. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAFFE EYE INSTITUTE PA
|
2009
|
591204805
|
2010-06-02
|
JAFFE EYE INSTITUTE, P.A.
|
25
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3059457433
|
Plan sponsor’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180
|
Plan administrator’s name and address
Administrator’s EIN |
591204805 |
Plan administrator’s name |
JAFFE EYE INSTITUTE, P.A. |
Plan administrator’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180 |
Administrator’s telephone number |
3059457433 |
Signature of
Role |
Plan administrator |
Date |
2010-06-02 |
Name of individual signing |
JAFFE EYE INSTITUTE, P.A. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
JAFFE EYE INSTITUTE PA
|
2009
|
591204805
|
2010-06-02
|
JAFFE EYE INSTITUTE, P.A.
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3059457433
|
Plan sponsor’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180
|
Plan administrator’s name and address
Administrator’s EIN |
591204805 |
Plan administrator’s name |
JAFFE EYE INSTITUTE, P.A. |
Plan administrator’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180 |
Administrator’s telephone number |
3059457433 |
Signature of
Role |
Plan administrator |
Date |
2010-06-02 |
Name of individual signing |
JAFFE EYE INSTITUTE, P.A. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAFFE EYE INSTITUTE PA
|
2009
|
591204805
|
2010-06-02
|
JAFFE EYE INSTITUTE, P.A.
|
25
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
3059457433
|
Plan sponsor’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180
|
Plan administrator’s name and address
Administrator’s EIN |
591204805 |
Plan administrator’s name |
JAFFE EYE INSTITUTE, P.A. |
Plan administrator’s
address |
18999 BISCAYNE BLVD., AVENTURA, FL, 33180 |
Administrator’s telephone number |
3059457433 |
Signature of
Role |
Plan administrator |
Date |
2010-06-02 |
Name of individual signing |
JAFFE EYE INSTITUTE, P.A. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|