|
FAIRFAX IMAGING, INC. 401(K) PLAN
|
2012
|
541701382
|
2013-09-12
|
FAIRFAX IMAGING, INC.
|
48
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
541511
|
| Sponsor’s telephone number |
7038021220
|
| Plan sponsor’s mailing address |
5215 W LAUREL STREET, SUITE 110, TAMPA, FL, 33607
|
| Plan sponsor’s
address |
5215 W LAUREL STREET, SUITE 110, TAMPA, FL, 33607
|
Plan administrator’s name and address
| Administrator’s EIN |
541701382 |
| Plan administrator’s name |
FAIRFAX IMAGING, INC. |
| Plan administrator’s
address |
5215 W LAUREL STREET, SUITE 110, TAMPA, FL, 33607 |
| Administrator’s telephone number |
7038021220 |
Number of participants as of the end of the plan year
| Active participants |
48 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
5 |
| 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 |
32 |
| 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 |
2013-09-12 |
| Name of individual signing |
STEVE CHAHAL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-09-12 |
| Name of individual signing |
STEVE CHAHAL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FAIRFAX IMAGING, INC. 401(K) PLAN
|
2011
|
541701382
|
2012-07-17
|
FAIRFAX IMAGING, INC.
|
52
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
541511
|
| Sponsor’s telephone number |
7038021220
|
| Plan sponsor’s mailing address |
5215 W LAUREL STREET, SUITE 110, TAMPA, FL, 33607
|
| Plan sponsor’s
address |
5215 W LAUREL STREET, SUITE 110, TAMPA, FL, 33607
|
Plan administrator’s name and address
| Administrator’s EIN |
541701382 |
| Plan administrator’s name |
FAIRFAX IMAGING, INC. |
| Plan administrator’s
address |
5215 W LAUREL STREET, SUITE 110, TAMPA, FL, 33607 |
| Administrator’s telephone number |
7038021220 |
Number of participants as of the end of the plan year
| Active participants |
44 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
4 |
| 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 |
33 |
| 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 |
2012-07-17 |
| Name of individual signing |
STEVE CHAHAL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FAIRFAX IMAGING, INC. 401(K) PLAN
|
2010
|
541701382
|
2011-04-07
|
FAIRFAX IMAGING, INC.
|
45
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
541511
|
| Sponsor’s telephone number |
7038021220
|
| Plan sponsor’s mailing address |
4921 MEMORIAL HIGHWAY, STE 114, TAMPA, FL, 33634
|
| Plan sponsor’s
address |
4921 MEMORIAL HIGHWAY, STE 114, TAMPA, FL, 33634
|
Plan administrator’s name and address
| Administrator’s EIN |
541701382 |
| Plan administrator’s name |
FAIRFAX IMAGING, INC. |
| Plan administrator’s
address |
4921 MEMORIAL HIGHWAY, STE 114, TAMPA, FL, 33634 |
| Administrator’s telephone number |
7038021220 |
Number of participants as of the end of the plan year
| Active participants |
43 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
9 |
| 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 |
33 |
| 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 |
2011-04-07 |
| Name of individual signing |
STEVE CHAHAL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
