|
O. SAMBANDAM, M.D., P.A. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2011
|
592063730
|
2013-05-31
|
O. SAMBANDAM, M.D., P.A.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-10-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416270323
|
| Plan sponsor’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952
|
Plan administrator’s name and address
| Administrator’s EIN |
592063730 |
| Plan administrator’s name |
O. SAMBANDAM, M.D., P.A. |
| Plan administrator’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952 |
| Administrator’s telephone number |
9416270323 |
Signature of
| Role |
Plan administrator |
| Date |
2013-05-31 |
| Name of individual signing |
ODAIYAPPA SAMBANDAM M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
O. SAMBANDAM, M.D., P.A. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2011
|
592063730
|
2013-05-31
|
O. SAMBANDAM, M.D., P.A.
|
4
|
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-10-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416270323
|
| Plan sponsor’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952
|
Plan administrator’s name and address
| Administrator’s EIN |
592063730 |
| Plan administrator’s name |
O. SAMBANDAM, M.D., P.A. |
| Plan administrator’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952 |
| Administrator’s telephone number |
9416270323 |
Signature of
| Role |
Plan administrator |
| Date |
2013-05-31 |
| Name of individual signing |
ODAIYAPPA SAMBANDAM M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
O. SAMBANDAM, M.D., P.A. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2010
|
592063730
|
2012-06-21
|
O. SAMBANDAM, M.D., P.A.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-10-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416270323
|
| Plan sponsor’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952
|
Plan administrator’s name and address
| Administrator’s EIN |
592063730 |
| Plan administrator’s name |
O. SAMBANDAM, M.D., P.A. |
| Plan administrator’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952 |
| Administrator’s telephone number |
9416270323 |
Signature of
| Role |
Plan administrator |
| Date |
2012-06-21 |
| Name of individual signing |
ODAIYAPPA SAMBANDAM |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
O. SAMBANDAM, M.D., P.A. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2009
|
592063730
|
2012-06-20
|
O. SAMBANDAM, M.D., P.A.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
2002-10-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416270323
|
| Plan sponsor’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952
|
Plan administrator’s name and address
| Administrator’s EIN |
592063730 |
| Plan administrator’s name |
O. SAMBANDAM, M.D., P.A. |
| Plan administrator’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952 |
| Administrator’s telephone number |
9416270323 |
Signature of
| Role |
Plan administrator |
| Date |
2012-06-20 |
| Name of individual signing |
ODAIYAPPA SAMBANDAM |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
O. SAMBANDAM, M.D., P.A. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2009
|
592063730
|
2011-07-15
|
O. SAMBANDAM, M.D., P.A.
|
4
|
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
2002-10-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416270323
|
| Plan sponsor’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952
|
Plan administrator’s name and address
| Administrator’s EIN |
592063730 |
| Plan administrator’s name |
O. SAMBANDAM, M.D., P.A. |
| Plan administrator’s
address |
2400 HARBOR BLVD., STE 8, PORT CHARLOTTE, FL, 33952 |
| Administrator’s telephone number |
9416270323 |
Signature of
| Role |
Plan administrator |
| Date |
2011-07-15 |
| Name of individual signing |
ODAIYAPPA SAMBANDAM |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
