|
PETER A. RUBELMAN, D.D.S., P.A. PROFIT SHARING PLAN
|
2013
|
650202277
|
2014-06-17
|
PETER A. RUBELMAN, D.D.S., P.A.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3053438794
|
| Plan sponsor’s mailing address |
3650 N. 36TH AVE. #48, HOLLYWOOD, FL, 33021
|
| Plan sponsor’s
address |
3650 N. 36TH AVE. #48, HOLLYWOOD, FL, 33021
|
Number of participants as of the end of the plan year
| Active participants |
0 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
0 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2014-06-17 |
| Name of individual signing |
PETER RUBELMAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PETER A. RUBELMAN, D.D.S., P.A. PROFIT SHARING PLAN
|
2012
|
650202277
|
2013-05-21
|
PETER A. RUBELMAN, D.D.S., P.A.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3056522255
|
| Plan sponsor’s mailing address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162
|
| Plan sponsor’s
address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162
|
Number of participants as of the end of the plan year
| Active participants |
3 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
3 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2013-05-20 |
| Name of individual signing |
PETER RUBELMAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PETER A. RUBELMAN, D.D.S., P.A. PROFIT SHARING PLAN
|
2011
|
650202277
|
2012-05-10
|
PETER A. RUBELMAN, D.D.S., P.A.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3056522255
|
| Plan sponsor’s mailing address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162
|
| Plan sponsor’s
address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162
|
Plan administrator’s name and address
| Administrator’s EIN |
650202277 |
| Plan administrator’s name |
PETER A. RUBELMAN, D.D.S., P.A. |
| Plan administrator’s
address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162 |
| Administrator’s telephone number |
3056522255 |
Number of participants as of the end of the plan year
| Active participants |
3 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
3 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2012-05-10 |
| Name of individual signing |
PETER RUBELMAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PETER A. RUBELMAN, D.D.S., P.A. PROFIT SHARING PLAN
|
2010
|
650202277
|
2011-05-04
|
PETER A. RUBELMAN, D.D.S., P.A.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3056522255
|
| Plan sponsor’s mailing address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162
|
| Plan sponsor’s
address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162
|
Plan administrator’s name and address
| Administrator’s EIN |
650202277 |
| Plan administrator’s name |
PETER A. RUBELMAN, D.D.S., P.A. |
| Plan administrator’s
address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162 |
| Administrator’s telephone number |
3056522255 |
Number of participants as of the end of the plan year
| Active participants |
3 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
3 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-05-04 |
| Name of individual signing |
PETER RUBELMAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PETER A. RUBELMAN, D.D.S., P.A. PROFIT SHARING PLAN
|
2009
|
650202277
|
2010-06-21
|
PETER A. RUBELMAN, D.D.S., P.A.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
1982-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3056522255
|
| Plan sponsor’s mailing address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162
|
| Plan sponsor’s
address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162
|
Plan administrator’s name and address
| Administrator’s EIN |
650202277 |
| Plan administrator’s name |
PETER A. RUBELMAN, D.D.S., P.A. |
| Plan administrator’s
address |
951 N.E. 167TH STREET STE 209, NORTH MIAMI BEACH, FL, 33162 |
| Administrator’s telephone number |
3056522255 |
Number of participants as of the end of the plan year
| Active participants |
3 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
3 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-06-21 |
| Name of individual signing |
PETER RUBELMAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
