|
GARY HURLBUT INSURANCE AGENCY INC AGE-WEIGHTED PROFIT SHARING PLAN
|
2014
|
592035613
|
2015-10-02
|
GARY HURLBUT INSURANCE AGENCY INC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1993-07-01
|
| Business code |
524210
|
| Sponsor’s telephone number |
4073419425
|
| Plan sponsor’s mailing address |
101 LONG LEAF LANE, ALTAMONTE SPRINGS, FL, 32714
|
| Plan sponsor’s
address |
101 LONG LEAF LANE, ALTAMONTE SPRINGS, FL, 32714
|
Number of participants as of the end of the plan year
| Other
retired or separated participants entitled to future benefits |
2 |
Signature of
| Role |
Plan administrator |
| Date |
2015-10-02 |
| Name of individual signing |
GARY HURLBUT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GARY HURLBUT INSURANCE AGENCY INC AGE-WEIGHTED PROFIT SHARING PLAN
|
2013
|
592035613
|
2015-08-19
|
GARY HURLBUT INSURANCE AGENCY INC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1993-07-01
|
| Business code |
524210
|
| Sponsor’s telephone number |
4073419425
|
| Plan sponsor’s mailing address |
101 LONG LEAF LANE, ALTAMONTE SPRINGS, FL, 32714
|
| Plan sponsor’s
address |
101 LONG LEAF LANE, ALTAMONTE SPRINGS, FL, 32714
|
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 |
2 |
| 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 |
2 |
| 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 |
2015-08-19 |
| Name of individual signing |
GARY HURLBUT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2015-08-19 |
| Name of individual signing |
GARY HURLBUT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GARY HURLBUT INSURANCE AGENCY, INC. AGE-WEIGHTED PROFIT SHARING PLAN
|
2010
|
592035613
|
2012-01-26
|
GARY HURLBUT INSURANCE AGENCY, INC.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1993-07-01
|
| Business code |
524210
|
| Sponsor’s telephone number |
4073419425
|
| Plan sponsor’s
address |
101 LONG LEAF LANE, ATLAMONTE SPRINGS, FL, 32714
|
Plan administrator’s name and address
| Administrator’s EIN |
592035613 |
| Plan administrator’s name |
GARY HURLBUT INSURANCE AGENCY, INC. |
| Plan administrator’s
address |
101 LONG LEAF LANE, ATLAMONTE SPRINGS, FL, 32714 |
| Administrator’s telephone number |
4073419425 |
Signature of
| Role |
Plan administrator |
| Date |
2012-01-26 |
| Name of individual signing |
GARY HURLBUT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-01-26 |
| Name of individual signing |
GARY HURLBUT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GARY HURLBUT INSURANCE AGENCY, INC. AGE-WEIGHTED PROFIT SHARING PLAN
|
2010
|
592035613
|
2012-01-26
|
GARY HURLBUT INSURANCE AGENCY, INC.
|
5
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1993-07-01
|
| Business code |
524210
|
| Sponsor’s telephone number |
4073419425
|
| Plan sponsor’s
address |
101 LONG LEAF LANE, ATLAMONTE SPRINGS, FL, 32714
|
Plan administrator’s name and address
| Administrator’s EIN |
592035613 |
| Plan administrator’s name |
GARY HURLBUT INSURANCE AGENCY, INC. |
| Plan administrator’s
address |
101 LONG LEAF LANE, ATLAMONTE SPRINGS, FL, 32714 |
| Administrator’s telephone number |
4073419425 |
Signature of
| Role |
Plan administrator |
| Date |
2012-01-26 |
| Name of individual signing |
GARY HURLBUT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-01-26 |
| Name of individual signing |
GARY HURLBUT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
