PHYSICIAN ADVISORY GROUP, INC. RETIREMENT PLAN AND TRUST
|
2019
|
593601570
|
2020-09-27
|
PHYSICIANS ADVISORY GROUP
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
541219
|
Sponsor’s telephone number |
3523798220
|
Plan sponsor’s
address |
300 INTRACOASTAL PLACE #208, TEQUESTA, FL, 33469
|
Signature of
Role |
Plan administrator |
Date |
2020-09-27 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-09-27 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN ADVISORY GROUP, INC. RETIREMENT PLAN AND TRUST
|
2018
|
593601570
|
2019-07-11
|
PHYSICIANS ADVISORY GROUP
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
541219
|
Sponsor’s telephone number |
3522154415
|
Plan sponsor’s
address |
300 INTRACOASTAL PLACE #208, TEQUESTA, FL, 33469
|
Signature of
Role |
Plan administrator |
Date |
2019-07-11 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-07-11 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN ADVISORY GROUP, INC. RETIREMENT PLAN AND TRUST
|
2017
|
593601570
|
2018-10-12
|
PHYSICIANS ADVISORY GROUP
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
541219
|
Sponsor’s telephone number |
3522247635
|
Plan sponsor’s
address |
2631 NW 41ST STREET, SUITE A, GAINESVILLE, FL, 32606
|
Signature of
Role |
Plan administrator |
Date |
2018-10-12 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-12 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN ADVISORY GROUP, INC. RETIREMENT PLAN AND TRUST
|
2016
|
593601570
|
2018-01-29
|
PHYSICIANS ADVISORY GROUP
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
541219
|
Sponsor’s telephone number |
3523798220
|
Plan sponsor’s
address |
2631 NW 41ST STREET, SUITE A, GAINESVILLE, FL, 32606
|
Signature of
Role |
Plan administrator |
Date |
2017-11-22 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-11-22 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN ADVISORY GROUP, INC. RETIREMENT PLAN AND TRUST
|
2015
|
593601570
|
2016-10-17
|
PHYSICIANS ADVISORY GROUP
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
541219
|
Sponsor’s telephone number |
3522247635
|
Plan sponsor’s
address |
2631 NW 41ST STREET BLDG A, GAINESVILLE, FL, 32606
|
Signature of
Role |
Plan administrator |
Date |
2016-10-17 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-17 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN ADVISORY GROUP, INC. RETIREMENT PLAN AND TRUST
|
2014
|
593601570
|
2015-10-15
|
PHYSICIANS ADVISORY GROUP
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
541219
|
Sponsor’s telephone number |
3523798220
|
Plan sponsor’s
address |
2631-A NW 41ST STREET, GAINESVILLE, FL, 32606
|
Signature of
Role |
Plan administrator |
Date |
2015-10-15 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-15 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN ADVISORY GROUP, INC. RETIREMENT PLAN AND TRUST
|
2013
|
593601570
|
2014-10-13
|
PHYSICIANS ADVISORY GROUP
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
541219
|
Sponsor’s telephone number |
3523798220
|
Plan sponsor’s
address |
2631-A NW 41ST STREET, GAINESVILLE, FL, 32606
|
Signature of
Role |
Plan administrator |
Date |
2014-10-13 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN ADVISORY GROUP, INC. RETIREMENT PLAN AND TRUST
|
2012
|
593601570
|
2013-09-17
|
PHYSICIANS ADVISORY GROUP
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
541219
|
Sponsor’s telephone number |
3523798220
|
Plan sponsor’s
address |
4110-D NW 37TH PLACE, GAINESVILLE, FL, 32606
|
Signature of
Role |
Plan administrator |
Date |
2013-09-16 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-09-16 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN ADVISORY GROUP, INC. RETIREMENT PLAN AND TRUST
|
2011
|
593601570
|
2012-10-15
|
PHYSICIANS ADVISORY GROUP
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
541219
|
Sponsor’s telephone number |
3523798220
|
Plan sponsor’s
address |
4110-D NW 37TH PLACE, GAINESVILLE, FL, 32606
|
Plan administrator’s name and address
Administrator’s EIN |
593601570 |
Plan administrator’s name |
PHYSICIANS ADVISORY GROUP |
Plan administrator’s
address |
4110-D NW 37TH PLACE, GAINESVILLE, FL, 32606 |
Administrator’s telephone number |
3523798220 |
Signature of
Role |
Plan administrator |
Date |
2012-10-15 |
Name of individual signing |
NEIL ROSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|