PETER J. CONGIUNDI, D.D.S., P.A. DEFINED BENEFIT PLAN
|
2014
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592567748
|
2015-10-02
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
2
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|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143
|
Plan administrator’s name and address
Administrator’s EIN |
592567748 |
Plan administrator’s name |
PETER J. CONGIUNDI, D.D.S., P.A. |
Plan administrator’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143 |
Administrator’s telephone number |
8509691060 |
Signature of
Role |
Plan administrator |
Date |
2015-10-02 |
Name of individual signing |
PETER CONGIUNDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER J. CONGIUNDI, D.D.S., P.A. 401(K) PLAN
|
2013
|
592567748
|
2014-08-14
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2003-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVENUE, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2014-08-14 |
Name of individual signing |
PETER J. CONGIUNDI, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-08-14 |
Name of individual signing |
PETER J. CONGIUNDI, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER J. CONGIUNDI, D.D.S., P.A. DEFINED BENEFIT PLAN
|
2013
|
592567748
|
2014-06-04
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143
|
Plan administrator’s name and address
Administrator’s EIN |
592567748 |
Plan administrator’s name |
PETER J. CONGIUNDI, D.D.S., P.A. |
Plan administrator’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143 |
Administrator’s telephone number |
8509691060 |
Signature of
Role |
Plan administrator |
Date |
2014-06-04 |
Name of individual signing |
PETER J. CONGIUNDI, DDS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER J. CONGIUNDI, D.D.S., P.A. DEFINED BENEFIT PLAN
|
2012
|
592567748
|
2013-07-29
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143
|
Plan administrator’s name and address
Administrator’s EIN |
592567748 |
Plan administrator’s name |
PETER J. CONGIUNDI, D.D.S., P.A. |
Plan administrator’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143 |
Administrator’s telephone number |
8509691060 |
Signature of
Role |
Plan administrator |
Date |
2013-07-29 |
Name of individual signing |
PETER J. CONGIUNDI, DDS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER J. CONGIUNDI, D.D.S., P.A. 401(K) PLAN
|
2012
|
592567748
|
2013-07-09
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2003-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVENUE, PENSACOLA, FL, 32504
|
Signature of
Role |
Plan administrator |
Date |
2013-07-09 |
Name of individual signing |
PETER J. CONGIUNDI, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER J. CONGIUNDI, D.D.S., P.A. DEFINED BENEFIT PLAN
|
2011
|
592567748
|
2012-10-12
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143
|
Plan administrator’s name and address
Administrator’s EIN |
592567748 |
Plan administrator’s name |
PETER J. CONGIUNDI, D.D.S., P.A. |
Plan administrator’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143 |
Administrator’s telephone number |
8509691060 |
Signature of
Role |
Plan administrator |
Date |
2012-10-12 |
Name of individual signing |
PETER J. CONGIUNDI, DDS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER J. CONGIUNDI, D.D.S., P.A. 401(K) PLAN
|
2011
|
592567748
|
2012-10-04
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2003-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVENUE, PENSACOLA, FL, 32504
|
Plan administrator’s name and address
Administrator’s EIN |
592567748 |
Plan administrator’s name |
PETER J. CONGIUNDI, D.D.S., P.A. |
Plan administrator’s
address |
6470 TIPPIN AVENUE, PENSACOLA, FL, 32504 |
Administrator’s telephone number |
8509691060 |
Signature of
Role |
Plan administrator |
Date |
2012-10-04 |
Name of individual signing |
PETER J. CONGIUNDI, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER J. CONGIUNDI, D.D.S., P.A. DEFINED BENEFIT PLAN
|
2010
|
592567748
|
2011-05-31
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143
|
Plan administrator’s name and address
Administrator’s EIN |
592567748 |
Plan administrator’s name |
PETER J. CONGIUNDI, D.D.S., P.A. |
Plan administrator’s
address |
6470 TIPPIN AVE., PENSACOLA, FL, 325048143 |
Administrator’s telephone number |
8509691060 |
Signature of
Role |
Plan administrator |
Date |
2011-05-31 |
Name of individual signing |
PETER J. CONGIUNDI, DDS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER J. CONGIUNDI, D.D.S., P.A. 401(K) PLAN
|
2010
|
592567748
|
2011-09-06
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2003-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVENUE, PENSACOLA, FL, 32504
|
Plan administrator’s name and address
Administrator’s EIN |
592567748 |
Plan administrator’s name |
PETER J. CONGIUNDI, D.D.S., P.A. |
Plan administrator’s
address |
6470 TIPPIN AVENUE, PENSACOLA, FL, 32504 |
Administrator’s telephone number |
8509691060 |
Signature of
Role |
Plan administrator |
Date |
2011-09-06 |
Name of individual signing |
PETER J. CONGIUNDI, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-09-06 |
Name of individual signing |
PETER J. CONGIUNDI, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER J. CONGIUNDI, D.D.S., P.A. 401(K) PLAN
|
2009
|
592567748
|
2010-10-07
|
PETER J. CONGIUNDI, D.D.S., P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2003-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8509691060
|
Plan sponsor’s
address |
6470 TIPPIN AVENUE, PENSACOLA, FL, 32504
|
Plan administrator’s name and address
Administrator’s EIN |
592567748 |
Plan administrator’s name |
PETER J. CONGIUNDI, D.D.S., P.A. |
Plan administrator’s
address |
6470 TIPPIN AVENUE, PENSACOLA, FL, 32504 |
Administrator’s telephone number |
8509691060 |
Signature of
Role |
Plan administrator |
Date |
2010-10-07 |
Name of individual signing |
PETER J. CONGIUNDI, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|