GOLDMAN, PLLC, DAVID LAW OFFICE OF 401(K) PSP
|
2023
|
262900567
|
2024-06-24
|
LAW OFFICE OF DAVID M. GOLDMAN
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
9046851200
|
Plan sponsor’s
address |
4115 HENDRICKS AVENUE, JACKSONVILLE, FL, 32207
|
Signature of
Role |
Plan administrator |
Date |
2024-06-24 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-06-24 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAW OFFICE OF DAVID M GOLDMAN PLLC MEDOVA LIFESTYLE HEALTH PLAN
|
2022
|
262900567
|
2023-11-01
|
LAW OFFICE OF DAVID M GOLDMAN PLLC
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2021-03-01
|
Business code |
541110
|
Sponsor’s telephone number |
9046851200
|
Plan sponsor’s
address |
4115 HENDRICKS AVE, JACKSONVILLE, FL, 322076323
|
Plan administrator’s name and address
Administrator’s EIN |
200200514 |
Plan administrator’s name |
RECEIVERSHIP MANAGEMENT, INC. |
Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
Administrator’s telephone number |
6153700051 |
Signature of
Role |
Plan administrator |
Date |
2023-11-01 |
Name of individual signing |
ROBERT MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GOLDMAN, PLLC, DAVID LAW OFFICE OF 401(K) PSP
|
2022
|
262900567
|
2023-07-13
|
LAW OFFICE OF DAVID M. GOLDMAN PLLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
9046851200
|
Plan sponsor’s
address |
4115 HENDRICKS AVENUE, JACKSONVILLE, FL, 32207
|
Signature of
Role |
Plan administrator |
Date |
2023-07-13 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-07-13 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAW OFFICE OF DAVID M GOLDMAN PLLC MEDOVA LIFESTYLE HEALTH PLAN
|
2021
|
262900567
|
2022-12-14
|
LAW OFFICE OF DAVID M GOLDMAN PLLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2021-03-01
|
Business code |
541110
|
Sponsor’s telephone number |
9046851200
|
Plan sponsor’s
address |
4115 HENDRICKS AVE, JACKSONVILLE, FL, 322076323
|
Plan administrator’s name and address
Administrator’s EIN |
200200514 |
Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
Administrator’s telephone number |
6153700051 |
Signature of
Role |
Plan administrator |
Date |
2022-12-14 |
Name of individual signing |
ROBERT MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GOLDMAN, PLLC, DAVID LAW OFFICE OF 401(K) PSP
|
2021
|
262900567
|
2022-07-14
|
LAW OFFICE OF DAVID M. GOLDMAN
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
9046851200
|
Plan sponsor’s
address |
4115 HENDRICKS AVENUE, JACKSONVILLE, FL, 32207
|
Signature of
Role |
Plan administrator |
Date |
2022-07-14 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-07-14 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GOLDMAN, PLLC, DAVID LAW OFFICE OF 401(K) PSP
|
2020
|
262900567
|
2021-06-16
|
LAW OFFICE OF DAVID M. GOLDMAN
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
9049908000
|
Plan sponsor’s
address |
4115 HENDRICKS AVENUE, JACKSONVILLE, FL, 32207
|
Signature of
Role |
Plan administrator |
Date |
2021-06-16 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-06-16 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GOLDMAN, PLLC, DAVID LAW OFFICE OF 401(K) PSP
|
2019
|
262900567
|
2020-06-15
|
LAW OFFICE OF DAVID M. GOLDMAN
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
9046851200
|
Plan sponsor’s
address |
4115 HENDRICKS AVENUE, JACKSONVILLE, FL, 32207
|
Signature of
Role |
Plan administrator |
Date |
2020-06-15 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-06-15 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GOLDMAN, PLLC, DAVID LAW OFFICE OF 401(K) PSP
|
2018
|
262900567
|
2019-07-01
|
LAW OFFICE OF DAVID M. GOLDMAN
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
9046851200
|
Plan sponsor’s
address |
3733 UNIVERSITY BLVD W, STE 212B, JACKSONVILLE, FL, 32217
|
Signature of
Role |
Plan administrator |
Date |
2019-07-01 |
Name of individual signing |
DAVID M GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-07-01 |
Name of individual signing |
DAVID M GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GOLDMAN, PLLC, DAVID LAW OFFICE OF 401(K) PSP
|
2017
|
262900567
|
2018-06-14
|
LAW OFFICE OF DAVID M. GOLDMAN
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
9046851200
|
Plan sponsor’s
address |
3733 UNIVERSITY BLVD W, STE 212B, JACKSONVILLE, FL, 32217
|
Signature of
Role |
Plan administrator |
Date |
2018-06-14 |
Name of individual signing |
BETH GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-14 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GOLDMAN, PLLC, DAVID LAW OFFICE OF 401(K) PSP
|
2016
|
262900567
|
2017-06-15
|
LAW OFFICE OF DAVID M. GOLDMAN
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
9046851200
|
Plan sponsor’s
address |
3733 UNIVERSITY BLVD W, STE 212B, JACKSONVILLE, FL, 32217
|
Signature of
Role |
Plan administrator |
Date |
2017-06-15 |
Name of individual signing |
BETH GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-15 |
Name of individual signing |
BETH GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|