|
LAKE COUNTY ANESTHESIA 401(K) PLAN
|
2012
|
593739273
|
2013-10-10
|
LAKE COUNTY ANESTHESIA ASSOCIATES, P.A.
|
32
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3523159005
|
| Plan sponsor’s mailing address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748
|
| Plan sponsor’s
address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748
|
Plan administrator’s name and address
| Administrator’s EIN |
593739273 |
| Plan administrator’s name |
LAKE COUNTY ANESTHESIA ASSOCIATES, P.A. |
| Plan administrator’s
address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748 |
| Administrator’s telephone number |
3523159005 |
Number of participants as of the end of the plan year
| Active participants |
29 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
6 |
| 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 |
35 |
| 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 |
2013-10-10 |
| Name of individual signing |
DEANNA BENDER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-10-10 |
| Name of individual signing |
DEANNA BENDER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKE COUNTY ANESTHESIA 401(K) PLAN
|
2011
|
593739273
|
2013-08-23
|
LAKE COUNTY ANESTHESIA ASSOCIATES, P.A.
|
32
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3523159005
|
| Plan sponsor’s mailing address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748
|
| Plan sponsor’s
address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748
|
Plan administrator’s name and address
| Administrator’s EIN |
593739273 |
| Plan administrator’s name |
LAKE COUNTY ANESTHESIA ASSOCIATES, P.A. |
| Plan administrator’s
address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748 |
| Administrator’s telephone number |
3523159005 |
Number of participants as of the end of the plan year
| Active participants |
28 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
6 |
| 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 |
33 |
| 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 |
2013-08-23 |
| Name of individual signing |
DEANNA BENDER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKE COUNTY ANESTHESIA 401(K) PLAN
|
2010
|
593739273
|
2011-06-28
|
LAKE COUNTY ANESTHESIA ASSOCIATES, P.A.
|
34
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3523159005
|
| Plan sponsor’s mailing address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748
|
| Plan sponsor’s
address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748
|
Plan administrator’s name and address
| Administrator’s EIN |
593739273 |
| Plan administrator’s name |
LAKE COUNTY ANESTHESIA ASSOCIATES, P.A. |
| Plan administrator’s
address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748 |
| Administrator’s telephone number |
3523159005 |
Number of participants as of the end of the plan year
| Active participants |
26 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
6 |
| 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 |
32 |
| 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 |
2011-06-28 |
| Name of individual signing |
DEANNA BENDER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKE COUNTY ANESTHESIA 401(K) PLAN
|
2009
|
593739273
|
2010-10-08
|
LAKE COUNTY ANESTHESIA ASSOCIATES, P.A.
|
30
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3523159005
|
| Plan sponsor’s mailing address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748
|
| Plan sponsor’s
address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748
|
Plan administrator’s name and address
| Administrator’s EIN |
593739273 |
| Plan administrator’s name |
LAKE COUNTY ANESTHESIA ASSOCIATES, P.A. |
| Plan administrator’s
address |
1023 MELLATHON CIRCLE, LEESBURG, FL, 34748 |
| Administrator’s telephone number |
3523159005 |
Number of participants as of the end of the plan year
| Active participants |
28 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
6 |
| 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 |
31 |
| 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 |
2010-10-08 |
| Name of individual signing |
DEANNA BENDER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
