|
BALDA HEALTH 401K PROFIT SHARING PLAN
|
2023
|
471453877
|
2024-08-23
|
BLUE ZONE HEALTH LLC
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
624100
|
| Sponsor’s telephone number |
4079295222
|
| Plan sponsor’s
address |
1000 SOUTH OLIVE AVENUE, WEST PALM BEACH, FL, 33401
|
Plan administrator’s name and address
| Administrator’s EIN |
621874769 |
| Plan administrator’s name |
ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES |
| Plan administrator’s
address |
6501 DEANE HILL DRIVE, KNONXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2024-08-23 |
| Name of individual signing |
TARA EVANS, FOR TAG RESOURCES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BALDA HEALTH 401K PROFIT SHARING PLAN
|
2022
|
471453877
|
2023-08-18
|
BLUE ZONE HEALTH LLC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
624100
|
| Sponsor’s telephone number |
4079295222
|
| Plan sponsor’s
address |
1000 SOUTH OLIVE AVENUE, WEST PALM BEACH, FL, 33401
|
Plan administrator’s name and address
| Administrator’s EIN |
621874769 |
| Plan administrator’s name |
ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES |
| Plan administrator’s
address |
6501 DEANE HILL DRIVE, KNONXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2023-08-18 |
| Name of individual signing |
TARA EVANS, FOR TAG RESOURCES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BALDA HEALTH 401K PROFIT SHARING PLAN
|
2021
|
471453877
|
2022-09-23
|
BLUE ZONE HEALTH LLC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2021-01-01
|
| Business code |
624100
|
| Sponsor’s telephone number |
4079295222
|
| Plan sponsor’s
address |
1000 NORTH OLIVE AVENUE, WEST PALM BEACH, FL, 33401
|
Plan administrator’s name and address
| Administrator’s EIN |
621874769 |
| Plan administrator’s name |
TAG RESOURCES, LLC |
| Plan administrator’s
address |
6501 DEANE HILL DRIVE, KNONXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2022-09-23 |
| Name of individual signing |
TARA EVANS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
