JAMES R. PITTS, II, D.M.D., P.A. ROTH 401(K) PLAN
|
2015
|
592992748
|
2016-10-07
|
JAMES R. PITTS, II, D.M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7277874746
|
Plan sponsor’s
address |
102 CARLYLE DR, PALM HARBOR, FL, 34683
|
|
JAMES R. PITTS, II, D.M.D., P.A. ROTH 401(K) PLAN
|
2014
|
592992748
|
2015-10-14
|
JAMES R. PITTS, II, D.M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7277874746
|
Plan sponsor’s
address |
102 CARLYLE DR, PALM HARBOR, FL, 34683
|
Signature of
Role |
Plan administrator |
Date |
2015-10-14 |
Name of individual signing |
JAMES R. PITTS, II |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAMES R. PITTS, II, D.M.D., P.A. DEFINED BENEFIT PLAN
|
2014
|
592992748
|
2015-10-06
|
JAMES R. PITTS, II, D.M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7276864068
|
Plan sponsor’s
address |
102 CARLYLE DR., PALM HARBOR, FL, 34683
|
Signature of
Role |
Plan administrator |
Date |
2015-10-06 |
Name of individual signing |
JAMES R. PITTS, II |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAMES R. PITTS, II, D.M.D., P.A. DEFINED BENEFIT PLAN
|
2013
|
592992748
|
2014-10-14
|
JAMES R. PITTS, II, D.M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7276864068
|
Plan sponsor’s
address |
102 CARLYLE DR., PALM HARBOR, FL, 34683
|
Signature of
Role |
Plan administrator |
Date |
2014-10-14 |
Name of individual signing |
JAMES R. PITTS, II |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAMES R. PITTS, II, D.M.D., P.A. DEFINED BENEFIT PLAN
|
2013
|
592992748
|
2014-10-13
|
JAMES R. PITTS, II, D.M.D., P.A.
|
2
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7276864068
|
Plan sponsor’s
address |
102 CARLYLE DR., PALM HARBOR, FL, 34683
|
Signature of
Role |
Plan administrator |
Date |
2014-10-13 |
Name of individual signing |
JAMES R. PITTS, II |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAMES R. PITTS, II, D.M.D., P.A. ROTH 401(K) PLAN
|
2013
|
592992748
|
2014-09-24
|
JAMES R. PITTS, II, D.M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7277874746
|
Plan sponsor’s
address |
2213 CURLEW ROAD, DUNEDIN, FL, 34698
|
|
JAMES R. PITTS, II, D.M.D., P.A. DEFINED BENEFIT PLAN
|
2012
|
592992748
|
2013-10-10
|
JAMES R. PITTS, II, D.M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7277874746
|
Plan sponsor’s
address |
2213 CURLEW ROAD, DUNEDIN, FL, 34698
|
Signature of
Role |
Plan administrator |
Date |
2013-10-10 |
Name of individual signing |
JAMES R. PITTS, II |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAMES R. PITTS, II, D.M.D., P.A. ROTH 401(K) PLAN
|
2012
|
592992748
|
2013-10-15
|
JAMES R. PITTS, II, D.M.D., P.A.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7277874746
|
Plan sponsor’s
address |
2213 CURLEW ROAD, DUNEDIN, FL, 34698
|
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
JAMES R. PITTS, II |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAMES R. PITTS, II, D.M.D., P.A. DEFINED BENEFIT PLAN
|
2011
|
592992748
|
2012-10-12
|
JAMES R. PITTS, II, D.M.D., P.A.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7277874746
|
Plan sponsor’s
address |
2213 CURLEW ROAD, DUNEDIN, FL, 34698
|
Plan administrator’s name and address
Administrator’s EIN |
592992748 |
Plan administrator’s name |
JAMES R. PITTS, II, D.M.D., P.A. |
Plan administrator’s
address |
2213 CURLEW ROAD, DUNEDIN, FL, 34698 |
Administrator’s telephone number |
7277874746 |
Signature of
Role |
Plan administrator |
Date |
2012-10-12 |
Name of individual signing |
JAMES R. PITTS, II |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAMES R. PITTS, II, D.M.D., P.A. ROTH 401(K) PLAN
|
2011
|
592992748
|
2012-10-14
|
JAMES R. PITTS, II, D.M.D., P.A.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
7277874746
|
Plan sponsor’s
address |
2213 CURLEW ROAD, DUNEDIN, FL, 34698
|
Plan administrator’s name and address
Administrator’s EIN |
592992748 |
Plan administrator’s name |
JAMES R. PITTS, II, D.M.D., P.A. |
Plan administrator’s
address |
2213 CURLEW ROAD, DUNEDIN, FL, 34698 |
Administrator’s telephone number |
7277874746 |
Signature of
Role |
Plan administrator |
Date |
2012-10-14 |
Name of individual signing |
JAMES R. PITTS, II |
Valid signature |
Filed with authorized/valid electronic signature |
|
|