|
COUNTRYSIDE NEUROLOGY, INC 401K PLAN
|
2023
|
200924147
|
2024-08-01
|
COUNTRYSIDE NEUROLOGY, INC
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7274631221
|
| Plan sponsor’s
address |
9806 NEW PARKE ROAD, TAMPA, FL, 33626
|
|
|
COUNTRYSIDE NEUROLOGY, INC 401K PLAN
|
2022
|
200924147
|
2023-09-20
|
COUNTRYSIDE NEUROLOGY, INC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7274631221
|
| Plan sponsor’s
address |
9806 NEW PARKE ROAD, TAMPA, FL, 33626
|
|
|
COUNTRYSIDE NEUROLOGY, INC 401K PLAN
|
2021
|
200924147
|
2022-10-11
|
COUNTRYSIDE NEUROLOGY, INC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7274631221
|
| Plan sponsor’s
address |
36181 EAST LAKE ROAD 268, PALM HARBOR, FL, 34685
|
Signature of
| Role |
Plan administrator |
| Date |
2022-10-11 |
| Name of individual signing |
ARDESHIR KHADEMI-KERMANSHAHI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
COUNTRYSIDE NEUROLOGY INC 401K PLAN
|
2020
|
200924147
|
2021-09-09
|
COUNTRYSIDE NEUROLOGY INC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7274631221
|
| Plan sponsor’s
address |
36181 EAST LAKE ROAD 268, PALM HARBOR, FL, 34685
|
Signature of
| Role |
Plan administrator |
| Date |
2021-09-09 |
| Name of individual signing |
ARDESHIR KHADEMI-KERMANSHAHI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
COUNTRYSIDE NEUROLOGY INC 401K PLAN
|
2019
|
200924147
|
2020-08-31
|
COUNTRYSIDE NEUROLOGY INC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7274631221
|
| Plan sponsor’s
address |
36181 EAST LAKE ROAD 268, PALM HARBOR, FL, 34685
|
Signature of
| Role |
Plan administrator |
| Date |
2020-08-31 |
| Name of individual signing |
ARDESHIR KHADEMI-KERMANSHAHI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
COUNTRYSIDE NEUROLOGY INC 401K PLAN
|
2018
|
200924147
|
2019-09-11
|
COUNTRYSIDE NEUROLOGY INC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7274631221
|
| Plan sponsor’s
address |
36181 EAST LAKE ROAD 268, PALM HARBOR, FL, 34685
|
Signature of
| Role |
Plan administrator |
| Date |
2019-09-11 |
| Name of individual signing |
ARDESHIR KHADEMI-KERMANSHAHI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
