LEESAR INC WELFARE BENEFITS PLAN
|
2014
|
263818222
|
2015-10-14
|
LEESAR INC
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
525
|
Effective date of plan |
2014-04-01
|
Business code |
561210
|
Sponsor’s telephone number |
2399398800
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LEESAR LIFE AND HEALTH INSURANCE
|
2013
|
263818222
|
2014-09-22
|
LEESAR INC
|
299
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2007-03-01
|
Business code |
561210
|
Sponsor’s telephone number |
2399398800
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-09-22 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-09-22 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LEESAR PREPAID LEGAL
|
2013
|
263818222
|
2014-09-22
|
LEESAR INC
|
34
|
|
File |
View Page
|
Three-digit plan number (PN) |
520
|
Effective date of plan |
2009-04-01
|
Business code |
561210
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-09-22 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-09-22 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LEESAR HEALTH INSURANCE
|
2013
|
263818222
|
2014-09-22
|
LEESAR INC
|
642
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2007-10-01
|
Business code |
561210
|
Sponsor’s telephone number |
2399398800
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-09-22 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-09-22 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LEESAR AFLAC PLAN
|
2013
|
263818222
|
2014-09-22
|
LEESAR INC
|
188
|
|
File |
View Page
|
Three-digit plan number (PN) |
515
|
Effective date of plan |
2009-05-01
|
Business code |
561210
|
Sponsor’s telephone number |
2399398800
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-09-22 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-09-22 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LEESAR AFLAC PLAN
|
2012
|
263818222
|
2013-12-02
|
LEESAR INC
|
118
|
|
File |
View Page
|
Three-digit plan number (PN) |
515
|
Effective date of plan |
2009-05-01
|
Business code |
561210
|
Sponsor’s telephone number |
2399398800
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-12-02 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-12-02 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LEESAR PREPAID LEGAL
|
2012
|
263818222
|
2013-09-19
|
LEESAR, INC.
|
40
|
|
File |
View Page
|
Three-digit plan number (PN) |
520
|
Effective date of plan |
2009-04-01
|
Business code |
561210
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-09-19 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LEESAR HEALTH INSURANCE
|
2012
|
263818222
|
2013-07-29
|
LEESAR INC
|
513
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2007-10-01
|
Business code |
561210
|
Sponsor’s telephone number |
2399398800
|
Plan
sponsor’s DBA name |
LEESAR REGIONAL SERVICE CENTER
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-29 |
Name of individual signing |
BARBARA FERNANDEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LEESAR LIFE AND HEALTH INSURANCE
|
2012
|
263818222
|
2013-04-16
|
LEESAR INC
|
239
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2007-03-01
|
Business code |
561210
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-04-16 |
Name of individual signing |
LINDA KLEINBROOK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LEESAR INC 401(K) PROFIT SHARING PLAN & TRUST
|
2011
|
263818222
|
2013-04-17
|
LEESAR INC
|
182
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
561210
|
Sponsor’s telephone number |
2399398712
|
Plan
sponsor’s DBA name |
LEESAR REGIONAL SERVICE CENTER
|
Plan sponsor’s mailing address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan sponsor’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901
|
Plan administrator’s name and address
Administrator’s EIN |
263818222 |
Plan administrator’s name |
LEESAR INC |
Plan administrator’s
address |
2727 WINKLER AVENUE, FORT MYERS, FL, 33901 |
Administrator’s telephone number |
2399398712 |
Number of participants as of the end of the plan year
Active participants |
247 |
Other
retired or separated participants entitled to future benefits |
12 |
Number of
participants
with
account balances as of the end of the plan year |
128 |
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 |
2013-04-17 |
Name of individual signing |
LINDA KLEINBROOK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|