JAY B. FARRIOR, M.D., P.A. 401(K) PLAN
|
2013
|
592694138
|
2014-06-05
|
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
8138790810
|
Plan sponsor’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000
|
Signature of
Role |
Plan administrator |
Date |
2014-06-05 |
Name of individual signing |
JAY B. FARRIOR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAY B. FARRIOR, M.D., P.A. 401(K) PLAN
|
2012
|
592694138
|
2013-10-15
|
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
8138790810
|
Plan sponsor’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000
|
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
JAY B. FARRIOR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAY B. FARRIOR, M.D., P.A. 401(K) PLAN
|
2011
|
592694138
|
2012-10-04
|
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
8138790810
|
Plan sponsor’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000
|
Plan administrator’s name and address
Administrator’s EIN |
592694138 |
Plan administrator’s name |
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION |
Plan administrator’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000 |
Administrator’s telephone number |
8138790810 |
Signature of
Role |
Plan administrator |
Date |
2012-10-04 |
Name of individual signing |
JAY B. FARRIOR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAY B. FARRIOR, M.D., P.A. 401(K) PLAN
|
2010
|
592694138
|
2011-10-10
|
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
8138790810
|
Plan sponsor’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000
|
Plan administrator’s name and address
Administrator’s EIN |
592694138 |
Plan administrator’s name |
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION |
Plan administrator’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000 |
Administrator’s telephone number |
8138790810 |
Signature of
Role |
Plan administrator |
Date |
2011-10-10 |
Name of individual signing |
JAY B. FARRIOR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAY B. FARRIOR, M.D., P.A. 401(K) PLAN
|
2009
|
592694138
|
2010-10-01
|
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION
|
7
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
8138790810
|
Plan sponsor’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000
|
Plan administrator’s name and address
Administrator’s EIN |
592694138 |
Plan administrator’s name |
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION |
Plan administrator’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000 |
Administrator’s telephone number |
8138790810 |
Signature of
Role |
Plan administrator |
Date |
2010-10-01 |
Name of individual signing |
JAY B. FARRIOR |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
JAY B. FARRIOR, M.D., P.A. 401(K) PLAN
|
2009
|
592694138
|
2010-10-04
|
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
8138790810
|
Plan sponsor’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000
|
Plan administrator’s name and address
Administrator’s EIN |
592694138 |
Plan administrator’s name |
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION |
Plan administrator’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000 |
Administrator’s telephone number |
8138790810 |
Signature of
Role |
Plan administrator |
Date |
2010-10-04 |
Name of individual signing |
JAY B. FARRIOR |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAY B. FARRIOR, M.D., P.A. 401(K) PLAN
|
2009
|
592694138
|
2010-10-04
|
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION
|
7
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-07-01
|
Business code |
621111
|
Sponsor’s telephone number |
8138790810
|
Plan sponsor’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000
|
Plan administrator’s name and address
Administrator’s EIN |
592694138 |
Plan administrator’s name |
JAY B. FARRIOR, M.D., PROFESSIONAL ASSOCIATION |
Plan administrator’s
address |
2727 W. MARTIN LUTHER KING BLVD., SUITE 520, TAMPA, FL, 336076000 |
Administrator’s telephone number |
8138790810 |
Signature of
Role |
Plan administrator |
Date |
2010-10-04 |
Name of individual signing |
JAY B. FARRIOR |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|