CLOSSON INSURANCE AGENCY, INC. PROFIT SHARING PLAN AND TRUST
|
2010
|
591892513
|
2010-12-17
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
1999-03-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s
address |
221 NORTH IVANHOE BLVD, ORLANDO, FL, 32804
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 NORTH IVANHOE BLVD, ORLANDO, FL, 32804 |
Administrator’s telephone number |
4078982211 |
Signature of
Role |
Employer/plan sponsor |
Date |
2010-12-16 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CLOSSON INSURANCE AGENCY, INC. PROFIT SHARING PLAN AND TRUST
|
2010
|
591892513
|
2011-01-12
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
1999-03-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s
address |
221 NORTH IVANHOE BLVD, ORLANDO, FL, 32804
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 NORTH IVANHOE BLVD, ORLANDO, FL, 32804 |
Administrator’s telephone number |
4078982211 |
Signature of
Role |
Plan administrator |
Date |
2011-01-12 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CLOSSON INSURANCE AGENCY, INC. PROFIT SHARING PLAN AND TRUST
|
2010
|
591892513
|
2011-01-12
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
1999-03-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s
address |
221 NORTH IVANHOE BLVD, ORLANDO, FL, 32804
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 NORTH IVANHOE BLVD, ORLANDO, FL, 32804 |
Administrator’s telephone number |
4078982211 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-01-12 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CLOSSON INSURANCE AGENCY, INC. PROFIT SHARING PLAN AND TRUST
|
2010
|
591892513
|
2010-12-20
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
1999-03-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s
address |
221 NORTH IVANHOE BLVD, ORLANDO, FL, 32804
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 NORTH IVANHOE BLVD, ORLANDO, FL, 32804 |
Administrator’s telephone number |
4078982211 |
Signature of
Role |
Plan administrator |
Date |
2010-12-20 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CLOSSON INSURANCE AGENCY, INC 401K PLAN
|
2009
|
591892513
|
2010-04-22
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1999-11-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s mailing address |
221 N.E. IVANHOE BLVD., SUITE 300, ORLANDO, FL, 328547275
|
Plan sponsor’s
address |
221 N.E. IVANHOE BLVD, SUITE 300, ORLANDO, FL, 328547275
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 N.E. IVANHOE BLVD., SUITE 300, ORLANDO, FL, 328547275 |
Administrator’s telephone number |
4078982211 |
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 |
2010-04-21 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-04-21 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CLOSSON INSURANCE AGENCY, INC. PROFIT SHARING PLAN
|
2009
|
591892513
|
2010-04-22
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
1999-03-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s mailing address |
221 N IVANHOE BLVD, SUITE 300, ORLANDO, FL, 328046488
|
Plan sponsor’s
address |
221 NE IVANHOE BLVD, SUITE 300, ORLANDO, FL, 328046488
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 N IVANHOE BLVD, SUITE 300, ORLANDO, FL, 328046488 |
Administrator’s telephone number |
4078982211 |
Number of participants as of the end of the plan year
Active participants |
1 |
Number of
participants
with
account balances as of the end of the plan year |
1 |
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 |
2010-04-21 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-04-21 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CLOSSON INSURANCE AGENCY, INC. PROFIT SHARING PLAN AND TRUST
|
2009
|
591892513
|
2010-03-17
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
1999-03-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s
address |
221 NORTH IVANHOE BOULEVARD, ORLANDO, FL, 32804
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 NORTH IVANHOE BOULEVARD, ORLANDO, FL, 32803 |
Administrator’s telephone number |
4078982211 |
Signature of
Role |
Plan administrator |
Date |
2010-03-17 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CLOSSON INSURANCE AGENCY, INC. PROFIT SHARING PLAN AND TRUST
|
2009
|
591892513
|
2010-03-17
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
1999-03-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s
address |
221 NORTH IVANHOE BOULEVARD, ORLANDO, FL, 32804
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 NORTH IVANHOE BOULEVARD, ORLANDO, FL, 32803 |
Administrator’s telephone number |
4078982211 |
Signature of
Role |
Plan administrator |
Date |
2010-03-17 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CLOSSON INSURANCE AGENCY, INC. PROFIT SHARING PLAN AND TRUST
|
2009
|
591892513
|
2010-03-17
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
1999-03-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s
address |
221 NORTH IVANHOE BOULEVARD, ORLANDO, FL, 32804
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 NORTH IVANHOE BOULEVARD, ORLANDO, FL, 32803 |
Administrator’s telephone number |
4078982211 |
Signature of
Role |
Plan administrator |
Date |
2010-03-17 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CLOSSON INSURANCE AGENCY, INC. PROFIT SHARING PLAN AND TRUST
|
2009
|
591892513
|
2010-03-17
|
CLOSSON INSURANCE AGENCY, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
1999-03-01
|
Business code |
524210
|
Sponsor’s telephone number |
4078982211
|
Plan sponsor’s
address |
221 NORTH IVANHOE BOULEVARD, ORLANDO, FL, 32804
|
Plan administrator’s name and address
Administrator’s EIN |
591892513 |
Plan administrator’s name |
CLOSSON INSURANCE AGENCY, INC. |
Plan administrator’s
address |
221 NORTH IVANHOE BOULEVARD, ORLANDO, FL, 32803 |
Administrator’s telephone number |
4078982211 |
Signature of
Role |
Plan administrator |
Date |
2010-03-17 |
Name of individual signing |
RODNEY CLOSSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|