|
COUNTRY SQUIRE INN, INC
|
2011
|
650177154
|
2012-08-13
|
COUNTRY SQUIRE INN, INC.
|
26
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
721110
|
| Sponsor’s telephone number |
5619685000
|
| Plan sponsor’s
address |
7859 LAKE WORTH ROAD, LAKE WORTH, FL, 33467
|
Plan administrator’s name and address
| Administrator’s EIN |
650177154 |
| Plan administrator’s name |
COUNTRY SQUIRE INN, INC. |
| Plan administrator’s
address |
7859 LAKE WORTH ROAD, LAKE WORTH, FL, 33467 |
| Administrator’s telephone number |
5619685000 |
Signature of
| Role |
Plan administrator |
| Date |
2012-08-13 |
| Name of individual signing |
MARK BEACHLER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
COUNTRY SQUIRE INN, INC
|
2011
|
650177154
|
2012-06-06
|
COUNTRY SQUIRE INN, INC.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
721110
|
| Sponsor’s telephone number |
5619685000
|
| Plan sponsor’s
address |
7859 LAKE WORTH ROAD, LAKE WORTH, FL, 33467
|
Plan administrator’s name and address
| Administrator’s EIN |
650177154 |
| Plan administrator’s name |
COUNTRY SQUIRE INN, INC. |
| Plan administrator’s
address |
7859 LAKE WORTH ROAD, LAKE WORTH, FL, 33467 |
| Administrator’s telephone number |
5619685000 |
Signature of
| Role |
Plan administrator |
| Date |
2012-06-06 |
| Name of individual signing |
MARK BEACHLER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
COUNTRY SQUIRE INN, INC
|
2010
|
650177154
|
2011-06-22
|
COUNTRY SQUIRE INN, INC.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
721110
|
| Sponsor’s telephone number |
5619685000
|
| Plan sponsor’s
address |
7859 LAKE WORTH ROAD, LAKE WORTH, FL, 33467
|
Plan administrator’s name and address
| Administrator’s EIN |
650177154 |
| Plan administrator’s name |
COUNTRY SQUIRE INN, INC. |
| Plan administrator’s
address |
7859 LAKE WORTH ROAD, LAKE WORTH, FL, 33467 |
| Administrator’s telephone number |
5619685000 |
Signature of
| Role |
Plan administrator |
| Date |
2011-06-22 |
| Name of individual signing |
MARK BEACHLER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
