|
PETER ALAN TUBY, M.D., P.A. EMPLOYEES PROFIT PLAN
|
2010
|
592019650
|
2011-06-03
|
PETER ALAN TUBY, M.D., P.A.
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1980-08-29
|
| Business code |
621111
|
| Sponsor’s telephone number |
5614960303
|
| Plan sponsor’s mailing address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529
|
| Plan sponsor’s
address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529
|
Plan administrator’s name and address
| Administrator’s EIN |
592019650 |
| Plan administrator’s name |
PETER ALAN TUBY, M.D., P.A. |
| Plan administrator’s
address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529 |
| Administrator’s telephone number |
5614960303 |
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 |
2011-06-01 |
| Name of individual signing |
PETER A. TUBY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PETER ALAN TUBY, M.D., P.A. EMPLOYEES PROFIT PLAN
|
2010
|
592019650
|
2011-06-02
|
PETER ALAN TUBY, M.D., P.A.
|
2
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1980-08-29
|
| Business code |
621111
|
| Sponsor’s telephone number |
5614960303
|
| Plan sponsor’s mailing address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529
|
| Plan sponsor’s
address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529
|
Plan administrator’s name and address
| Administrator’s EIN |
592019650 |
| Plan administrator’s name |
PETER ALAN TUBY, M.D., P.A. |
| Plan administrator’s
address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529 |
| Administrator’s telephone number |
5614960303 |
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 |
2011-06-01 |
| Name of individual signing |
PETER A. TUBY |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
|
PETER ALAN TUBY, M.D., P.A. EMPLOYEES PROFIT SHARING PLAN
|
2009
|
592019650
|
2010-06-11
|
PETER ALAN TUBY, M.D., P.A.
|
2
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1980-08-29
|
| Business code |
621111
|
| Sponsor’s telephone number |
5614960303
|
| Plan sponsor’s mailing address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529
|
| Plan sponsor’s
address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529
|
Plan administrator’s name and address
| Administrator’s EIN |
592019650 |
| Plan administrator’s name |
PETER ALAN TUBY, M.D., P.A. |
| Plan administrator’s
address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529 |
| Administrator’s telephone number |
5614960303 |
Number of participants as of the end of the plan year
| Active participants |
2 |
| 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 |
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 |
2010-07-15 |
| Name of individual signing |
PETER A. TUBY |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
|
PETER ALAN TUBY, M.D., P.A. EMPLOYEES PROFIT SHARING PLAN
|
2009
|
592019650
|
2010-06-16
|
PETER ALAN TUBY, M.D., P.A.
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1980-08-29
|
| Business code |
621111
|
| Sponsor’s telephone number |
5614960303
|
| Plan sponsor’s mailing address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529
|
| Plan sponsor’s
address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529
|
Plan administrator’s name and address
| Administrator’s EIN |
592019650 |
| Plan administrator’s name |
PETER ALAN TUBY, M.D., P.A. |
| Plan administrator’s
address |
5258 LINTON BOULEVARD, SUITE 201, DELRAY BEACH, FL, 334846529 |
| Administrator’s telephone number |
5614960303 |
Number of participants as of the end of the plan year
| Active participants |
2 |
| 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 |
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 |
2010-06-16 |
| Name of individual signing |
PETER A. TUBY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
