GEORGE R. TERSHAKOVEC, M.D., P.A. 401(K) PLAN
|
2011
|
030391974
|
2012-10-03
|
GEORGE R. TERSHAKOVEC, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7862438701
|
Plan sponsor’s
address |
HOMESTEAD HOSPITAL, 975 BAPTIST WAY 2ND FL, HOMESTEAD, FL, 33033
|
Plan administrator’s name and address
Administrator’s EIN |
030391974 |
Plan administrator’s name |
GEORGE R. TERSHAKOVEC, M.D., P.A. |
Plan administrator’s
address |
HOMESTEAD HOSPITAL, 975 BAPTIST WAY 2ND FL, HOMESTEAD, FL, 33033 |
Administrator’s telephone number |
7862438701 |
Signature of
Role |
Plan administrator |
Date |
2012-10-03 |
Name of individual signing |
GEORGE R. TERSHAKOVEC |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-03 |
Name of individual signing |
GEORGE R. TERSHAKOVEC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEORGE R. TERSHAKOVEC, M.D., P.A. 401(K) PLAN
|
2010
|
030391974
|
2011-07-29
|
GEORGE R. TERSHAKOVEC, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7862438701
|
Plan sponsor’s
address |
975 BAPTIST WAY, SUITE 201, HOMESTEAD HOSPITAL, HOMESTEAD, FL, 33033
|
Plan administrator’s name and address
Administrator’s EIN |
030391974 |
Plan administrator’s name |
GEORGE R. TERSHAKOVEC, M.D., P.A. |
Plan administrator’s
address |
975 BAPTIST WAY, SUITE 201, HOMESTEAD HOSPITAL, HOMESTEAD, FL, 33033 |
Administrator’s telephone number |
7862438701 |
Signature of
Role |
Plan administrator |
Date |
2011-07-29 |
Name of individual signing |
GEORGE TERSHAKOVEC |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-29 |
Name of individual signing |
GEORGE TERSHAKOVEC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEORGE R. TERSHAKOVEC, M.D., P.A. 401(K) PLAN
|
2009
|
030391974
|
2010-07-28
|
GEORGE R. TERSHAKOVEC, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7862438701
|
Plan sponsor’s
address |
975 BAPTIST WAY SUITE 201, HOMESTEAD HOSPITAL, HOMESTEAD, FL, 33033
|
Plan administrator’s name and address
Administrator’s EIN |
030391974 |
Plan administrator’s name |
GEORGE R. TERSHAKOVEC, M.D., P.A. |
Plan administrator’s
address |
975 BAPTIST WAY SUITE 201, HOMESTEAD HOSPITAL, HOMESTEAD, FL, 33033 |
Administrator’s telephone number |
7862438701 |
Signature of
Role |
Plan administrator |
Date |
2010-07-28 |
Name of individual signing |
GEORGE R. TERSHAKOVEC |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-28 |
Name of individual signing |
GEORGE R. TERSHAKOVEC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|