|
ANTHEM REPORTING 401(K) P/S PLAN
|
2022
|
273787684
|
2023-05-04
|
ANTHEM SERVICES, LLC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
541190
|
| Sponsor’s telephone number |
8132722720
|
| Plan sponsor’s
address |
4909 YACHT CLUB DR, TAMPA, FL, 33616
|
Signature of
| Role |
Plan administrator |
| Date |
2023-05-04 |
| Name of individual signing |
KEVIN BRANAGAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2023-05-04 |
| Name of individual signing |
KEVIN BRANAGAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ANTHEM REPORTING 401(K) P/S PLAN
|
2022
|
273787684
|
2023-04-12
|
ANTHEM SERVICES, LLC
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
541190
|
| Sponsor’s telephone number |
8132722720
|
| Plan sponsor’s
address |
4909 YACHT CLUB DR, TAMPA, FL, 33616
|
Signature of
| Role |
Plan administrator |
| Date |
2023-04-12 |
| Name of individual signing |
KEVIN BRANAGAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ANTHEM REPORTING 401(K) P/S PLAN
|
2022
|
273787684
|
2023-02-21
|
ANTHEM SERVICES, LLC
|
8
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
541190
|
| Sponsor’s telephone number |
8132722720
|
| Plan sponsor’s
address |
4909 YACHT CLUB DR, TAMPA, FL, 33616
|
Signature of
| Role |
Plan administrator |
| Date |
2023-02-21 |
| Name of individual signing |
KEVIN BRANAGAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ANTHEM REPORTING 401(K) P/S PLAN
|
2021
|
273787684
|
2022-05-10
|
ANTHEM SERVICES, LLC
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
541190
|
| Sponsor’s telephone number |
8132722720
|
| Plan sponsor’s
address |
101 S FRANKLIN ST STE 101, TAMPA, FL, 33602
|
Plan administrator’s name and address
| Administrator’s EIN |
273787684 |
| Plan administrator’s name |
ANTHEM SERVICES, LLC |
| Plan administrator’s
address |
101 S FRANKLIN ST STE 101, TAMPA, FL, 33602 |
| Administrator’s telephone number |
8132722720 |
Signature of
| Role |
Plan administrator |
| Date |
2022-05-10 |
| Name of individual signing |
KEVIN BRANAGAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
