|
5 STAR HOME HEALTH SERVICES 401(K) PLAN
|
2010
|
030547616
|
2012-01-30
|
5 STAR HOME HEALTH SERVICES, INC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
4072962610
|
| Plan sponsor’s
address |
5104 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101013
|
Plan administrator’s name and address
| Administrator’s EIN |
030547616 |
| Plan administrator’s name |
5 STAR HOME HEALTH SERVICES, INC |
| Plan administrator’s
address |
5104 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101013 |
| Administrator’s telephone number |
4072962610 |
Signature of
| Role |
Plan administrator |
| Date |
2012-01-30 |
| Name of individual signing |
WAYNE JACQUES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-01-30 |
| Name of individual signing |
WAYNE JACQUES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
5 STAR HOME HEALTH SERVICES 401(K) PLAN
|
2010
|
030547616
|
2012-01-18
|
5 STAR HOME HEALTH SERVICES, INC
|
5
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
4072962610
|
| Plan sponsor’s
address |
5104 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101013
|
Plan administrator’s name and address
| Administrator’s EIN |
030547616 |
| Plan administrator’s name |
5 STAR HOME HEALTH SERVICES, INC |
| Plan administrator’s
address |
5104 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101013 |
| Administrator’s telephone number |
4072962610 |
Signature of
| Role |
Plan administrator |
| Date |
2012-01-18 |
| Name of individual signing |
WAYNE JACQUES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-01-18 |
| Name of individual signing |
WAYNE JACQUES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
5 STAR HOME HEALTH SERVICES 401(K) PLAN
|
2010
|
030547616
|
2011-11-28
|
5 STAR HOME HEALTH SERVICES, INC
|
5
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
4072962610
|
| Plan sponsor’s
address |
5104 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101013
|
Plan administrator’s name and address
| Administrator’s EIN |
030547616 |
| Plan administrator’s name |
5 STAR HOME HEALTH SERVICES, INC |
| Plan administrator’s
address |
5104 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101013 |
| Administrator’s telephone number |
4072962610 |
Signature of
| Role |
Plan administrator |
| Date |
2011-11-28 |
| Name of individual signing |
WAYNE JACQUES |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-11-28 |
| Name of individual signing |
WAYNE JACQUES |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
|
5 STAR HOME HEALTH SERVICES 401(K) PLAN
|
2009
|
030547616
|
2010-06-07
|
5 STAR HOME HEALTH SERVICES, INC.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
4072962610
|
| Plan sponsor’s
address |
5104 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101042
|
Plan administrator’s name and address
| Administrator’s EIN |
030547616 |
| Plan administrator’s name |
5 STAR HOME HEALTH SERVICES, INC. |
| Plan administrator’s
address |
5104 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101042 |
| Administrator’s telephone number |
4072962610 |
Signature of
| Role |
Plan administrator |
| Date |
2010-06-07 |
| Name of individual signing |
WAYNE JACQUES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-06-07 |
| Name of individual signing |
WAYNE JACQUES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
