ROBERT J. DORFF, M.D., P.A. PROFIT SHARING PLAN
|
2017
|
592595827
|
2018-10-03
|
ROBERT J. DORFF, M.D., P.A.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
4075995900
|
Plan sponsor’s
address |
440 SOUTH LAKE SYBELIA DRIVE, MAITLAND, FL, 32751
|
Signature of
Role |
Plan administrator |
Date |
2018-10-03 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-03 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT J. DORFF, M.D., P.A. PROFIT SHARING PLAN
|
2016
|
592595827
|
2017-09-25
|
ROBERT J. DORFF, M.D., P.A.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
4075995900
|
Plan sponsor’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2017-09-25 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT J. DORFF, M.D., P.A. PROFIT SHARING PLAN
|
2015
|
592595827
|
2016-10-14
|
ROBERT J. DORFF, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
4075995900
|
Plan sponsor’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2016-10-14 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT J. DORFF, M.D., P.A. PROFIT SHARING PLAN
|
2014
|
592595827
|
2015-10-08
|
ROBERT J. DORFF, M.D., P.A.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
4075995900
|
Plan sponsor’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2015-10-08 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT J. DORFF, M.D., P.A. PROFIT SHARING PLAN
|
2013
|
592595827
|
2014-10-10
|
ROBERT J. DORFF, M.D., P.A.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
4075995900
|
Plan sponsor’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2014-10-10 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT J. DORFF, M.D., P.A. PROFIT SHARING PLAN
|
2012
|
592595827
|
2013-09-09
|
ROBERT J. DORFF, M.D., P.A.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
4075995900
|
Plan sponsor’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2013-09-09 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT J. DORFF, M.D., P.A. PROFIT SHARING PLAN
|
2011
|
592595827
|
2012-09-20
|
ROBERT J. DORFF, M.D., P.A.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
4075995900
|
Plan sponsor’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792
|
Plan administrator’s name and address
Administrator’s EIN |
592595827 |
Plan administrator’s name |
ROBERT J. DORFF, M.D., P.A. |
Plan administrator’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792 |
Administrator’s telephone number |
4075995900 |
Signature of
Role |
Plan administrator |
Date |
2012-09-20 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT J. DORFF, M.D., P.A. PROFIT SHARING PLAN
|
2010
|
592595827
|
2011-10-12
|
ROBERT J. DORFF, M.D., P.A.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
4075995900
|
Plan sponsor’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792
|
Plan administrator’s name and address
Administrator’s EIN |
592595827 |
Plan administrator’s name |
ROBERT J. DORFF, M.D., P.A. |
Plan administrator’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792 |
Administrator’s telephone number |
4075995900 |
Signature of
Role |
Plan administrator |
Date |
2011-10-12 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT J. DORFF, M.D., P.A. PROFIT SHARING PLAN
|
2009
|
592595827
|
2010-10-06
|
ROBERT J. DORFF, M.D., P.A.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
4075995900
|
Plan sponsor’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792
|
Plan administrator’s name and address
Administrator’s EIN |
592595827 |
Plan administrator’s name |
ROBERT J. DORFF, M.D., P.A. |
Plan administrator’s
address |
1925 MIZELL AVENUE, SUITE 204, WINTER PARK, FL, 32792 |
Administrator’s telephone number |
4075995900 |
Signature of
Role |
Plan administrator |
Date |
2010-10-06 |
Name of individual signing |
ROBERT J. DORFF, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|