|
AVECINA MEDICAL PA 401 K PROFIT SHARING PLAN TRUST
|
2012
|
201628686
|
2013-07-30
|
AVECINA MEDICAL, P.A.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9042306988
|
| Plan sponsor’s
address |
1633 RACE TRACK RD STE 101, SAINT JOHNS, FL, 322593237
|
Signature of
| Role |
Plan administrator |
| Date |
2013-07-30 |
| Name of individual signing |
AVECINA MEDICAL, P.A. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
AVECINA MEDICAL PA 401 K PROFIT SHARING PLAN TRUST
|
2011
|
201628686
|
2013-07-30
|
AVECINA MEDICAL, P.A.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9042306988
|
| Plan sponsor’s
address |
1633 RACE TRACK RD STE 101, SAINT JOHNS, FL, 322593237
|
Plan administrator’s name and address
| Administrator’s EIN |
201628686 |
| Plan administrator’s name |
AVECINA MEDICAL, P.A. |
| Plan administrator’s
address |
1633 RACE TRACK RD STE 101, SAINT JOHNS, FL, 322593237 |
| Administrator’s telephone number |
9042306988 |
Signature of
| Role |
Plan administrator |
| Date |
2013-07-30 |
| Name of individual signing |
AVECINA MEDICAL, P.A. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
AVECINA MEDICAL PA 401 K PROFIT SHARING PLAN TRUST
|
2010
|
201628686
|
2013-07-30
|
AVECINA MEDICAL, P.A.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9042306988
|
| Plan sponsor’s
address |
9580 APPLECROSS RD SUITE 106, JACKSONVILLE, FL, 32222
|
Plan administrator’s name and address
| Administrator’s EIN |
201628686 |
| Plan administrator’s name |
AVECINA MEDICAL, P.A. |
| Plan administrator’s
address |
9580 APPLECROSS RD SUITE 106, JACKSONVILLE, FL, 32222 |
| Administrator’s telephone number |
9042306988 |
Signature of
| Role |
Plan administrator |
| Date |
2013-07-30 |
| Name of individual signing |
AVECINA MEDICAL, P.A. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
AVECINA MEDICAL PA
|
2009
|
201628686
|
2010-07-29
|
AVECINA MEDICAL, P.A.
|
13
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9042306988
|
| Plan sponsor’s
address |
9580 APPLECROSS RD SUITE 106, JACKSONVILLE, FL, 32222
|
Plan administrator’s name and address
| Administrator’s EIN |
201628686 |
| Plan administrator’s name |
AVECINA MEDICAL, P.A. |
| Plan administrator’s
address |
9580 APPLECROSS RD SUITE 106, JACKSONVILLE, FL, 32222 |
| Administrator’s telephone number |
9042306988 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-29 |
| Name of individual signing |
AVECINA MEDICAL, P.A. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
