|
DAVID CROWELL, M.D., P.A., 401(K) PROFIT SHARING PLAN
|
2011
|
592792751
|
2012-08-31
|
DAVID CROWELL, M.D., P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1987-01-30
|
| Business code |
621111
|
| Sponsor’s telephone number |
5617984455
|
| Plan sponsor’s
address |
10131 FOREST HILL BOULEVARD, SUITE, WELLINGTON, FL, 33414
|
Plan administrator’s name and address
| Administrator’s EIN |
592792751 |
| Plan administrator’s name |
DAVID CROWELL, M.D., P.A. |
| Plan administrator’s
address |
10131 FOREST HILL BOULEVARD, SUITE, WELLINGTON, FL, 33414 |
| Administrator’s telephone number |
5617984455 |
Signature of
| Role |
Plan administrator |
| Date |
2012-08-31 |
| Name of individual signing |
J DAVID CROWELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-08-31 |
| Name of individual signing |
J DAVID CROWELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
DAVID CROWELL, M.D., P.A., 401(K) PROFIT SHARING PLAN
|
2010
|
592792751
|
2011-09-15
|
DAVID CROWELL, M.D., P.A.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1987-01-30
|
| Business code |
621111
|
| Sponsor’s telephone number |
5617984455
|
| Plan sponsor’s
address |
10131 FOREST HILL BOULEVARD, SUITE, WELLINGTON, FL, 33414
|
Plan administrator’s name and address
| Administrator’s EIN |
592792751 |
| Plan administrator’s name |
DAVID CROWELL, M.D., P.A. |
| Plan administrator’s
address |
10131 FOREST HILL BOULEVARD, SUITE, WELLINGTON, FL, 33414 |
| Administrator’s telephone number |
5617984455 |
Signature of
| Role |
Plan administrator |
| Date |
2011-09-15 |
| Name of individual signing |
JOHN D CROWELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-09-15 |
| Name of individual signing |
JOHN D CROWELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
DAVID CROWELL, M.D., P.A., 401(K) PROFIT SHARING PLAN
|
2009
|
592792751
|
2010-10-05
|
DAVID CROWELL, M.D., P.A.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1987-01-30
|
| Business code |
621111
|
| Sponsor’s telephone number |
5617984455
|
| Plan sponsor’s
address |
10131 FOREST HILL BOULEVARD, SUITE, WELLINGTON, FL, 33414
|
Plan administrator’s name and address
| Administrator’s EIN |
592792751 |
| Plan administrator’s name |
DAVID CROWELL, M.D., P.A. |
| Plan administrator’s
address |
10131 FOREST HILL BOULEVARD, SUITE, WELLINGTON, FL, 33414 |
| Administrator’s telephone number |
5617984455 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-05 |
| Name of individual signing |
JOHN CROWELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-10-05 |
| Name of individual signing |
JOHN CROWELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
