BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2023
|
593629143
|
2024-04-30
|
BEACHES EAR, NOSE AND THROAT, P.A.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3200 S. 3RD STREET, SUITE 101, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2024-04-30 |
Name of individual signing |
KEVIN CHEEZUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2022
|
593629143
|
2023-07-24
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BEACHES EAR, NOSE AND THROAT, P.A.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3200 S. 3RD STREET, SUITE 101, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2023-07-24 |
Name of individual signing |
KEVIN CHEEZUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2021
|
593629143
|
2022-07-28
|
BEACHES EAR, NOSE AND THROAT, P.A.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3200 S. 3RD STREET, SUITE 101, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2022-07-28 |
Name of individual signing |
KEVIN CHEEZUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2020
|
593629143
|
2021-06-09
|
BEACHES EAR, NOSE AND THROAT, P.A.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3200 S. 3RD STREET, SUITE 101, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2021-06-09 |
Name of individual signing |
JEFFREY BRINK, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2019
|
593629143
|
2020-09-29
|
BEACHES EAR, NOSE AND THROAT, P.A.
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3200 S. 3RD STREET, SUITE 101, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2020-09-29 |
Name of individual signing |
JEFFREY BRINK, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2018
|
593629143
|
2019-05-06
|
BEACHES EAR, NOSE AND THROAT, P.A.
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3200 S. 3RD STREET, SUITE 101, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2019-05-06 |
Name of individual signing |
JEFFREY BRINK, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2017
|
593629143
|
2018-07-09
|
BEACHES EAR, NOSE AND THROAT, P.A.
|
19
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3200 S. 3RD STREET, SUITE 101, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2018-07-09 |
Name of individual signing |
JEFFREY BRINK, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2016
|
593629143
|
2017-05-12
|
BEACHES EAR, NOSE AND THROAT, P.A.
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3200 S. 3RD STREET, SUITE 101, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2017-05-12 |
Name of individual signing |
JEFFREY BRINK, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2015
|
593629143
|
2016-08-09
|
BEACHES EAR, NOSE AND THROAT, P.A.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3200 S. 3RD STREET, SUITE 101, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2016-08-09 |
Name of individual signing |
JEFFREY BRINK, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEACHES EAR, NOSE AND THROAT, P.A. PROFIT SHARING PLAN AND TRUST
|
2014
|
593629143
|
2015-10-06
|
BEACHES EAR, NOSE AND THROAT, P.A.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9042474070
|
Plan sponsor’s
address |
3316 SOUTH 3RD ST, STE 102, JACKSONVILLE BEACH, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2015-10-06 |
Name of individual signing |
JEFFREY BRINK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-06 |
Name of individual signing |
JEFFREY BRINK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|