|
SENIOR HEALTH CARE OF VOLUSIA, P.A. PROFIT SHARING PLAN
|
2010
|
593666446
|
2011-07-21
|
SENIOR HEALTH CARE OF VOLUSIA, P.A.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3862524178
|
| Plan sponsor’s
address |
405 N. CLYDE MORRIS BLVD., DAYTONA BE, FL, 32114
|
Plan administrator’s name and address
| Administrator’s EIN |
593666446 |
| Plan administrator’s name |
SENIOR HEALTH CARE OF VOLUSIA, P.A. |
| Plan administrator’s
address |
405 N. CLYDE MORRIS BLVD., DAYTONA BE, FL, 32114 |
| Administrator’s telephone number |
3862524178 |
Signature of
| Role |
Plan administrator |
| Date |
2011-07-21 |
| Name of individual signing |
TATIANA CHAVEZ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-07-21 |
| Name of individual signing |
TATIANA CHAVEZ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SENIOR HEALTH CARE OF VOLUSIA, P.A. DEFINED BENEFIT PLAN
|
2010
|
593666446
|
2011-07-22
|
SENIOR HEALTH CARE OF VOLUSIA, P.A.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3862524178
|
| Plan sponsor’s
address |
405 N. CLYDE MORRIS BLVD., DAYTONA BE, FL, 32114
|
Plan administrator’s name and address
| Administrator’s EIN |
593666446 |
| Plan administrator’s name |
SENIOR HEALTH CARE OF VOLUSIA, P.A. |
| Plan administrator’s
address |
405 N. CLYDE MORRIS BLVD., DAYTONA BE, FL, 32114 |
| Administrator’s telephone number |
3862524178 |
Signature of
| Role |
Plan administrator |
| Date |
2011-07-22 |
| Name of individual signing |
TATIANA CHAVEZ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-07-22 |
| Name of individual signing |
TATIANA CHAVEZ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SENIOR HEALTH CARE OF VOLUSIA, P.A. PROFIT SHARING PLAN
|
2009
|
593666446
|
2010-09-08
|
SENIOR HEALTH CARE OF VOLUSIA, P.A.
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3862524178
|
| Plan sponsor’s
address |
405 N. CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114
|
Plan administrator’s name and address
| Administrator’s EIN |
593666446 |
| Plan administrator’s name |
SENIOR HEALTH CARE OF VOLUSIA, P.A. |
| Plan administrator’s
address |
405 N. CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114 |
| Administrator’s telephone number |
3862524178 |
Signature of
| Role |
Plan administrator |
| Date |
2010-09-08 |
| Name of individual signing |
JULIE BURGESS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SENIOR HEALTH CARE OF VOLUSIA, P.A. DEFINED BENEFIT PLAN
|
2009
|
593666446
|
2010-09-08
|
SENIOR HEALTH CARE OF VOLUSIA, P.A.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3862524178
|
| Plan sponsor’s
address |
405 N. CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114
|
Plan administrator’s name and address
| Administrator’s EIN |
593666446 |
| Plan administrator’s name |
SENIOR HEALTH CARE OF VOLUSIA, P.A. |
| Plan administrator’s
address |
405 N. CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114 |
| Administrator’s telephone number |
3862524178 |
Signature of
| Role |
Plan administrator |
| Date |
2010-09-08 |
| Name of individual signing |
JULIE BURGESS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
