TERRY L. CARLSON, P.A. 401(K) PLAN
|
2023
|
200706666
|
2024-07-17
|
TERRY L. CARLSON, P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-10-01
|
Business code |
531210
|
Sponsor’s telephone number |
2397706955
|
Plan sponsor’s
address |
1428 NW 25TH PL., CAPE CORAL, FL, 33993
|
Signature of
Role |
Plan administrator |
Date |
2024-07-17 |
Name of individual signing |
TERRY L CARLSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TERRY L. CARLSON, P.A. 401(K) PLAN
|
2022
|
200706666
|
2023-05-11
|
TERRY L. CARLSON, P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-10-01
|
Business code |
531210
|
Sponsor’s telephone number |
2397706955
|
Plan sponsor’s
address |
1428 NW 25TH PL., CAPE CORAL, FL, 33993
|
Signature of
Role |
Plan administrator |
Date |
2023-05-11 |
Name of individual signing |
TERRY L CARLSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TERRY L. CARLSON, P.A. 401(K) PLAN
|
2021
|
200706666
|
2022-07-15
|
TERRY L. CARLSON, P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-10-01
|
Business code |
531210
|
Sponsor’s telephone number |
2395428611
|
Plan sponsor’s
address |
3208 CHIQUITA BLVD S., #204, CAPE CORAL, FL, 33914
|
Signature of
Role |
Plan administrator |
Date |
2022-07-15 |
Name of individual signing |
TERRY L CARLSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TERRY L. CARLSON, P.A. 401(K) PLAN
|
2020
|
200706666
|
2021-04-28
|
TERRY L. CARLSON, P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-10-01
|
Business code |
531210
|
Sponsor’s telephone number |
2395428611
|
Plan sponsor’s
address |
3208 CHIQUITA BLVD S., #204, CAPE CORAL, FL, 33914
|
Signature of
Role |
Plan administrator |
Date |
2021-04-28 |
Name of individual signing |
TERRY L CARLSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TERRY L. CARLSON, P.A. 401(K) PLAN
|
2019
|
200706666
|
2020-06-01
|
TERRY L. CARLSON, P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-10-01
|
Business code |
531210
|
Sponsor’s telephone number |
2395428611
|
Plan sponsor’s
address |
3208 CHIQUITA BLVD S., #204, CAPE CORAL, FL, 33914
|
Signature of
Role |
Plan administrator |
Date |
2020-06-01 |
Name of individual signing |
TERRY L CARLSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TERRY L. CARLSON, P.A. 401(K) PLAN
|
2018
|
200706666
|
2019-06-19
|
TERRY L. CARLSON, P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-10-01
|
Business code |
531210
|
Sponsor’s telephone number |
2395428611
|
Plan sponsor’s
address |
3208 CHIQUITA BLVD S., #204, CAPE CORAL, FL, 33914
|
Signature of
Role |
Plan administrator |
Date |
2019-06-19 |
Name of individual signing |
TERRY L CARLSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TERRY L. CARLSON, P.A. 401(K) PLAN
|
2017
|
200706666
|
2018-06-29
|
TERRY L. CARLSON, P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-10-01
|
Business code |
531210
|
Sponsor’s telephone number |
2395428611
|
Plan sponsor’s
address |
725 CAPE CORAL PKWY W., CAPE CORAL, FL, 33914
|
Signature of
Role |
Plan administrator |
Date |
2018-06-29 |
Name of individual signing |
TERRY L CARLSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TERRY L. CARLSON, P.A. 401(K) PLAN
|
2016
|
200706666
|
2017-10-02
|
TERRY L. CARLSON, P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-10-01
|
Business code |
531210
|
Sponsor’s telephone number |
2395428611
|
Plan sponsor’s
address |
725 CAPE CORAL PKWY W., CAPE CORAL, FL, 33914
|
Signature of
Role |
Plan administrator |
Date |
2017-10-02 |
Name of individual signing |
TERRY L CARLSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|