|
PALM HARBOR PEDIATRICS, P.A. 401(K) PLAN
|
2014
|
592922707
|
2015-07-20
|
PALM HARBOR PEDIATRICS, P.A.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7277874944
|
| Plan sponsor’s
address |
2595 SR 584, STE W, PALM HARBOR, FL, 34684
|
Signature of
| Role |
Plan administrator |
| Date |
2015-07-20 |
| Name of individual signing |
ENID GAUD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALM HARBOR PEDIATRICS, P.A. 401(K) PLAN
|
2013
|
592922707
|
2015-06-12
|
PALM HARBOR PEDIATRICS, P.A.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7277874944
|
| Plan sponsor’s
address |
2595 SR 584, STE W, PALM HARBOR, FL, 34684
|
Signature of
| Role |
Plan administrator |
| Date |
2015-06-12 |
| Name of individual signing |
ENID GAUD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALM HARBOR PEDIATRICS, P.A. 401(K) PLAN
|
2012
|
592922707
|
2014-04-02
|
PALM HARBOR PEDIATRICS, P.A.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7277874944
|
| Plan sponsor’s
address |
2595 SR 584, STE W, PALM HARBOR, FL, 34684
|
Signature of
| Role |
Plan administrator |
| Date |
2014-04-02 |
| Name of individual signing |
ENID GAUD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALM HARBOR PEDIATRICS, P.A. 401(K) PLAN
|
2011
|
592922707
|
2013-01-09
|
PALM HARBOR PEDIATRICS, P.A.
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7277874944
|
| Plan sponsor’s
address |
2595 SR 584, STE W, PALM HARBOR, FL, 34684
|
Plan administrator’s name and address
| Administrator’s EIN |
592922707 |
| Plan administrator’s name |
PALM HARBOR PEDIATRICS, P.A. |
| Plan administrator’s
address |
2595 SR 584, STE W, PALM HARBOR, FL, 34684 |
| Administrator’s telephone number |
7277874944 |
Signature of
| Role |
Plan administrator |
| Date |
2013-01-09 |
| Name of individual signing |
ENID GAUD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALM HARBOR PEDIATRICS, P.A. 401(K) PLAN
|
2010
|
592922707
|
2012-04-27
|
PALM HARBOR PEDIATRICS, P.A.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7277874944
|
| Plan sponsor’s
address |
2595 SR 584, STE W, PALM HARBOR, FL, 34684
|
Plan administrator’s name and address
| Administrator’s EIN |
592922707 |
| Plan administrator’s name |
PALM HARBOR PEDIATRICS, P.A. |
| Plan administrator’s
address |
2595 SR 584, STE W, PALM HARBOR, FL, 34684 |
| Administrator’s telephone number |
7277874944 |
Signature of
| Role |
Plan administrator |
| Date |
2012-04-27 |
| Name of individual signing |
ENID GAUD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALM HARBOR PEDIATRICS, P.A. 401(K) PLAN
|
2009
|
592922707
|
2011-04-27
|
PALM HARBOR PEDIATRICS, P.A.
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7277874944
|
| Plan sponsor’s
address |
2595 SR 584, STE W, PALM HARBOR, FL, 34684
|
Plan administrator’s name and address
| Administrator’s EIN |
592922707 |
| Plan administrator’s name |
PALM HARBOR PEDIATRICS, P.A. |
| Plan administrator’s
address |
2595 SR 584, STE W, PALM HARBOR, FL, 34684 |
| Administrator’s telephone number |
7277874944 |
Signature of
| Role |
Plan administrator |
| Date |
2011-04-27 |
| Name of individual signing |
ENID GAUD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
