|
JENS CHRISTIAN CARLSEN, D.O., PLLC 401(K) PLAN & TRUST
|
2023
|
814813851
|
2024-06-06
|
JENS CHRISTIAN CARLSEN, D.O., PLLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9414210756
|
| Plan sponsor’s
address |
2525 HARBOR BLVD., SUITE 301, PORT CHARLOTTE, FL, 339525342
|
Signature of
| Role |
Plan administrator |
| Date |
2024-06-06 |
| Name of individual signing |
IRA CARLSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JENS CHRISTIAN CARLSEN, D.O., PLLC 401(K) PLAN & TRUST
|
2022
|
814813851
|
2023-12-05
|
JENS CHRISTIAN CARLSEN, D.O., PLLC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9414210756
|
| Plan sponsor’s
address |
2525 HARBOR BLVD., SUITE 301, PORT CHARLOTTE, FL, 339525342
|
Signature of
| Role |
Plan administrator |
| Date |
2023-12-05 |
| Name of individual signing |
IRA CARLSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JENS CHRISTIAN CARLSEN, D.O., PLLC 401(K) PLAN & TRUST
|
2022
|
814813851
|
2023-06-06
|
JENS CHRISTIAN CARLSEN, D.O., PLLC
|
4
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9414210756
|
| Plan sponsor’s
address |
2525 HARBOR BLVD., SUITE 301, PORT CHARLOTTE, FL, 339525342
|
Signature of
| Role |
Plan administrator |
| Date |
2023-06-06 |
| Name of individual signing |
IRA CARLSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JENS CHRISTIAN CARLSEN, D.O., PLLC 401(K) PLAN & TRUST
|
2021
|
814813851
|
2023-02-15
|
JENS CHRISTIAN CARLSEN, D.O., PLLC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9414210756
|
| Plan sponsor’s
address |
2525 HARBOR BLVD., SUITE 301, PORT CHARLOTTE, FL, 339525342
|
Signature of
| Role |
Plan administrator |
| Date |
2023-02-15 |
| Name of individual signing |
IRA CARLSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JENS CHRISTIAN CARLSEN, D.O., PLLC 401(K) PLAN & TRUST
|
2020
|
814813851
|
2021-10-11
|
JENS CHRISTIAN CARLSEN, D.O., PLLC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9414210756
|
| Plan sponsor’s
address |
2525 HARBOR BLVD., SUITE 301, PORT CHARLOTTE, FL, 339525342
|
Signature of
| Role |
Plan administrator |
| Date |
2021-10-11 |
| Name of individual signing |
IRA CARLSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JENS CHRISTIAN CARLSEN, D.O., PLLC 401(K) PLAN & TRUST
|
2019
|
814813851
|
2020-10-12
|
JENS CHRISTIAN CARLSEN, D.O., PLLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9414210756
|
| Plan sponsor’s
address |
2525 HARBOR BLVD., SUITE 301, PORT CHARLOTTE, FL, 339525342
|
Signature of
| Role |
Plan administrator |
| Date |
2020-10-12 |
| Name of individual signing |
IRA CARLSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
