|
ROSS HAZELTINE LCC 401(K)
|
2023
|
852220166
|
2024-08-12
|
ROSS HAZELTINE LLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-09-01
|
| Business code |
484120
|
| Sponsor’s telephone number |
8475337677
|
| Plan sponsor’s
address |
33 S GULFSTREAM AVE, UNIT 1008, SARASOTA, FL, 34236
|
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, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2024-08-12 |
| Name of individual signing |
TARA EVANS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ROSS HAZELTINE LCC 401(K)
|
2022
|
852220166
|
2023-07-27
|
ROSS HAZELTINE LLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-09-01
|
| Business code |
484120
|
| Sponsor’s telephone number |
8475337677
|
| Plan sponsor’s
address |
33 S GULFSTREAM AVE, UNIT 1008, SARASOTA, FL, 34236
|
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, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2023-07-27 |
| Name of individual signing |
TARA EVANS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ROSS HAZELTINE LCC 401(K)
|
2021
|
852220166
|
2022-07-29
|
ROSS HAZELTINE LLC
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-09-01
|
| Business code |
484120
|
| Sponsor’s telephone number |
8475337677
|
| Plan sponsor’s
address |
33 S GULFSTREAM AVE, UNIT 704A, SARASOTA, FL, 34236
|
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, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2022-07-29 |
| Name of individual signing |
TARA EVANS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ROSS HAZELTINE LCC 401(K)
|
2020
|
852220166
|
2021-10-13
|
ROSS HAZELTINE LLC
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-09-01
|
| Business code |
484120
|
| Sponsor’s telephone number |
8475337677
|
| Plan sponsor’s
address |
33 S GULFSTREAM AVE, UNIT 704A, SARASOTA, FL, 34236
|
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, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2021-10-13 |
| Name of individual signing |
PHIL TISUE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
