SHREEKANT K. TRIPATHI, M.D. PROFIT SHARING PLAN
|
2014
|
202893424
|
2015-07-06
|
SHREEKANT K. TRIPATHI, M.D., P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636880536
|
Plan sponsor’s
address |
520 EAST GARDEN STREET, LAKELAND, FL, 33805
|
Signature of
Role |
Plan administrator |
Date |
2015-07-06 |
Name of individual signing |
SHREEKANT K. TRIPATHI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHREEKANT K. TRIPATHI, M.D. PROFIT SHARING PLAN
|
2013
|
202893424
|
2014-07-25
|
SHREEKANT K. TRIPATHI, M.D., P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636880536
|
Plan sponsor’s
address |
520 EAST GARDEN STREET, LAKELAND, FL, 33805
|
Signature of
Role |
Plan administrator |
Date |
2014-07-25 |
Name of individual signing |
SHREEKANT K. TRIPATHI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-25 |
Name of individual signing |
SHREEKANT K. TRIPATHI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHREEKANT K. TRIPATHI, M.D. PROFIT SHARING PLAN
|
2012
|
202893424
|
2013-10-07
|
SHREEKANT K. TRIPATHI, M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636880536
|
Plan sponsor’s
address |
520 EAST GARDEN STREET, LAKELAND, FL, 33805
|
Signature of
Role |
Plan administrator |
Date |
2013-10-07 |
Name of individual signing |
SHREEKANT K. TRIPATHI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHREEKANT K. TRIPATHI, M.D. PROFIT SHARING PLAN
|
2011
|
202893424
|
2012-10-10
|
SHREEKANT K. TRIPATHI, M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636880536
|
Plan sponsor’s
address |
520 EAST GARDEN STREET, LAKELAND, FL, 33805
|
Plan administrator’s name and address
Administrator’s EIN |
202893424 |
Plan administrator’s name |
SHREEKANT K. TRIPATHI, M.D., P.A. |
Plan administrator’s
address |
520 EAST GARDEN STREET, LAKELAND, FL, 33805 |
Administrator’s telephone number |
8636880536 |
Signature of
Role |
Plan administrator |
Date |
2012-10-09 |
Name of individual signing |
SHREEKANT K. TRIPATHI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHREEKANT K. TRIPATHI, M.D. PROFIT SHARING PLAN
|
2010
|
202893424
|
2011-10-14
|
SHREEKANT K. TRIPATHI, M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636880536
|
Plan sponsor’s
address |
520 EAST GARDEN STREET, LAKELAND, FL, 33805
|
Plan administrator’s name and address
Administrator’s EIN |
202893424 |
Plan administrator’s name |
SHREEKANT K. TRIPATHI, M.D., P.A. |
Plan administrator’s
address |
520 EAST GARDEN STREET, LAKELAND, FL, 33805 |
Administrator’s telephone number |
8636880536 |
Signature of
Role |
Plan administrator |
Date |
2011-10-13 |
Name of individual signing |
SHREEKANT K. TRIPATHI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-10-13 |
Name of individual signing |
SHREEKANT K TRIPATHI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHREEKANT K. TRIPATHI, M.D. PROFIT SHARING PLAN
|
2009
|
202893424
|
2010-10-11
|
SHREEKANT K. TRIPATHI, M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1985-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636880536
|
Plan sponsor’s
address |
520 EAST GARDEN STREET, LAKELAND, FL, 33805
|
Plan administrator’s name and address
Administrator’s EIN |
202893424 |
Plan administrator’s name |
SHREEKANT K. TRIPATHI, M.D., P.A. |
Plan administrator’s
address |
520 EAST GARDEN STREET, LAKELAND, FL, 33805 |
Administrator’s telephone number |
8636880536 |
Signature of
Role |
Plan administrator |
Date |
2010-10-11 |
Name of individual signing |
SHREEKANT K. TRIPATHI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|