AMELIA ANESTHESIA 401(K) PLAN
|
2023
|
461507376
|
2024-07-23
|
AMELIA ANESTHESIA, PL
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
P. O. BOX 15159, FERNANDINA BEACH, FL, 32035
|
|
AMELIA ANESTHESIA 401(K) PLAN
|
2022
|
461507376
|
2023-08-15
|
AMELIA ANESTHESIA, PL
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
P. O. BOX 15159, FERNANDINA BEACH, FL, 32035
|
Signature of
Role |
Plan administrator |
Date |
2023-08-15 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AMELIA ANESTHESIA 401(K) PLAN
|
2021
|
461507376
|
2022-09-02
|
AMELIA ANESTHESIA, PL
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
PO BOX 15159, FERNANDINA BEACH, FL, 32034
|
Signature of
Role |
Plan administrator |
Date |
2022-09-02 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AMELIA ANESTHESIA 401(K) PLAN
|
2020
|
461507376
|
2021-06-10
|
AMELIA ANESTHESIA, PL
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
PO BOX 15159, FERNANDINA BEACH, FL, 32035
|
Signature of
Role |
Plan administrator |
Date |
2021-06-10 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AMELIA ANESTHESIA 401(K) PLAN
|
2019
|
461507376
|
2020-07-07
|
AMELIA ANESTHESIA, PL
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
95429 BARNWELL ROAD, FERNANDINA BEACH, FL, 32034
|
Signature of
Role |
Plan administrator |
Date |
2020-07-07 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AMELIA ANESTHESIA 401(K) PLAN
|
2018
|
461507376
|
2019-06-10
|
AMELIA ANESTHESIA, PL
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
95429 BARNWELL ROAD, FERNANDINA BEACH, FL, 32034
|
Signature of
Role |
Plan administrator |
Date |
2019-06-10 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AMELIA ANESTHESIA 401(K) PLAN
|
2017
|
461507376
|
2018-07-18
|
AMELIA ANESTHESIA, PL
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
95429 BARNWELL ROAD, FERNANDINA BEACH, FL, 32034
|
Signature of
Role |
Plan administrator |
Date |
2018-07-18 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AMELIA ANESTHESIA 401(K) PLAN
|
2016
|
461507376
|
2017-06-20
|
AMELIA ANESTHESIA, PL
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
95429 BARNWELL ROAD, FERNANDINA BEACH, FL, 32034
|
Signature of
Role |
Plan administrator |
Date |
2017-06-20 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AMELIA ANESTHESIA RETIREMENT PLAN
|
2015
|
461507376
|
2016-09-29
|
AMELIA ANESTHESIA, PL
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
95429 BARNWELL ROAD, FERNANDINA BEACH, FL, 320341698
|
Signature of
Role |
Plan administrator |
Date |
2016-09-29 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-09-29 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AMELIA ANESTHESIA RETIREMENT PLAN
|
2014
|
461507376
|
2015-06-11
|
AMELIA ANESTHESIA, PL
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-08-15
|
Business code |
621399
|
Sponsor’s telephone number |
9042616221
|
Plan sponsor’s
address |
95429 BARNWELL ROAD, FERNANDINA BEACH, FL, 320341698
|
Signature of
Role |
Plan administrator |
Date |
2015-06-11 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-06-11 |
Name of individual signing |
JASON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|