|
SAMANTHA CARELLA PYSD & ASSOC 401K PLAN
|
2012
|
030383490
|
2013-06-10
|
SAMANTHA CARELLA, PSY.D. & ASSOCIATES, P.A.
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
621330
|
| Sponsor’s telephone number |
3056629162
|
| Plan sponsor’s
address |
2925 AVENTURA BLVD., SUITE 300, AVENTURA, FL, 33180
|
Plan administrator’s name and address
| Administrator’s EIN |
030383490 |
| Plan administrator’s name |
SAMANTHA CARELLA, PSY.D. & ASSOCIATES, P.A. |
| Plan administrator’s
address |
2925 AVENTURA BLVD., SUITE 300, AVENTURA, FL, 33180 |
| Administrator’s telephone number |
3056629162 |
Signature of
| Role |
Plan administrator |
| Date |
2013-06-10 |
| Name of individual signing |
SAMANTHA CARELLA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-06-10 |
| Name of individual signing |
SAMANTHA CARELLA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SAMANTHA CARELLA PYSD & ASSOC 401K PLAN
|
2011
|
030383490
|
2012-07-25
|
SAMANTHA CARELLA, PSY.D. & ASSOCIATES, P.A.
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
621330
|
| Sponsor’s telephone number |
3056629162
|
| Plan sponsor’s
address |
2925 AVENTURA BLVD., SUITE 300, AVENTURA, FL, 33180
|
Plan administrator’s name and address
| Administrator’s EIN |
030383490 |
| Plan administrator’s name |
SAMANTHA CARELLA, PSY.D. & ASSOCIATES, P.A. |
| Plan administrator’s
address |
2925 AVENTURA BLVD., SUITE 300, AVENTURA, FL, 33180 |
| Administrator’s telephone number |
3056629162 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-25 |
| Name of individual signing |
SAMANTHA CARELLA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SAMANTHA CARELLA PYSD & ASSOC 401K PLAN
|
2010
|
030383490
|
2011-10-03
|
SAMANTHA CARELLA, PSY.D. & ASSOCIATES, P.A.
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
621330
|
| Sponsor’s telephone number |
3056629162
|
| Plan sponsor’s
address |
2925 AVENTURA BLVD., SUITE 300, AVENTURA, FL, 33180
|
Plan administrator’s name and address
| Administrator’s EIN |
030383490 |
| Plan administrator’s name |
SAMANTHA CARELLA, PSY.D. & ASSOCIATES, P.A. |
| Plan administrator’s
address |
2925 AVENTURA BLVD., SUITE 300, AVENTURA, FL, 33180 |
| Administrator’s telephone number |
3056629162 |
Signature of
| Role |
Plan administrator |
| Date |
2011-10-02 |
| Name of individual signing |
SAMANTHA CARELLA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SAMANTHA CARELLA PYSD & ASSOC 401K PLAN
|
2009
|
030383490
|
2010-10-07
|
SAMANTHA CARELLA, PSY.D. & ASSOCIATES, P.A.
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
621330
|
| Sponsor’s telephone number |
3056629162
|
| Plan sponsor’s
address |
2925 AVENTURA BLVD., SUITE 300, AVENTURA, FL, 33180
|
Plan administrator’s name and address
| Administrator’s EIN |
030383490 |
| Plan administrator’s name |
SAMANTHA CARELLA, PSY.D. & ASSOCIATES, P.A. |
| Plan administrator’s
address |
2925 AVENTURA BLVD., SUITE 300, AVENTURA, FL, 33180 |
| Administrator’s telephone number |
3056629162 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-06 |
| Name of individual signing |
SAMANTHA CARELLA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
