SUPERMARKET SOURCE INC 401(K) PROFIT SHARING PLAN & TRUST
|
2021
|
203568017
|
2022-05-18
|
SUPERMARKET SOURCE INC
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
423400
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2540 W 84TH ST UNIT 1, HIALEAH, FL, 330165756
|
Signature of
Role |
Plan administrator |
Date |
2022-05-18 |
Name of individual signing |
WYNIFRETH BURGOS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUPERMARKET SOURCE INC 401(K) PROFIT SHARING PLAN & TRUST
|
2020
|
203568017
|
2021-07-02
|
SUPERMARKET SOURCE INC
|
20
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
423400
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2540 W 84TH STREET, UNIT #1, HIALEAH, FL, 330165608
|
Signature of
Role |
Plan administrator |
Date |
2021-07-02 |
Name of individual signing |
RAUL VIZCAINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUPERMARKET SOURCE INC 401(K) PROFIT SHARING PLAN & TRUST
|
2019
|
203568017
|
2020-04-09
|
SUPERMARKET SOURCE INC
|
19
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
423400
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2741 W 76TH ST, HIALEAH, FL, 330165608
|
Signature of
Role |
Plan administrator |
Date |
2020-04-09 |
Name of individual signing |
RAUL VIZCAINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUPERMARKET SOURCE INC 401 K PROFIT SHARING PLAN TRUST
|
2018
|
203568017
|
2019-03-20
|
SUPERMARKET SOURCE INC
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
423400
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2741 W 76TH ST, HIALEAH, FL, 330165608
|
Signature of
Role |
Plan administrator |
Date |
2019-03-20 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUPERMARKET SOURCE INC. 401 K PROFIT SHARING PLAN TRUST
|
2017
|
203568017
|
2018-07-20
|
SUPERMARKET SOURCE INC
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
423400
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2741 W 76TH ST, HIALEAH, FL, 330165608
|
Signature of
Role |
Plan administrator |
Date |
2018-07-20 |
Name of individual signing |
FRANCES BURGOS-DEOLIVEIRA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUPERMARKET SOURCE INC 401(K) PROFIT SHARING PLAN & TRUST
|
2015
|
203568017
|
2016-05-02
|
SUPERMARKET SOURCE INC
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2500 W 84TH ST, SUITE 3, HIALEAH, FL, 33016
|
Signature of
Role |
Plan administrator |
Date |
2016-05-02 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-05-02 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUPERMARKET SOURCE INC 401(K) PROFIT SHARING PLAN & TRUST
|
2014
|
203568017
|
2015-02-20
|
SUPERMARKET SOURCE INC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2500 W 84TH ST, SUITE 3, HIALEAH, FL, 33016
|
Signature of
Role |
Plan administrator |
Date |
2015-02-20 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-02-20 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUPERMARKET SOURCE INC 401(K) PROFIT SHARING PLAN & TRUST
|
2013
|
203568017
|
2014-03-11
|
SUPERMARKET SOURCE INC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2500 W 84TH ST, SUITE 3, HIALEAH, FL, 33016
|
Signature of
Role |
Plan administrator |
Date |
2014-03-11 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-03-11 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUPERMARKET SOURCE INC 401(K) PROFIT SHARING PLAN & TRUST
|
2012
|
203568017
|
2013-02-27
|
SUPERMARKET SOURCE INC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2500 W 84TH ST, SUITE 3, HIALEAH, FL, 33016
|
Signature of
Role |
Plan administrator |
Date |
2013-02-27 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-02-27 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUPERMARKET SOURCE INC 401(K) PROFIT SHARING PLAN & TRUST
|
2011
|
203568017
|
2012-07-17
|
SUPERMARKET SOURCE INC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
3058274700
|
Plan sponsor’s
address |
2500 W 84TH ST, SUITE 3, HIALEAH, FL, 33016
|
Plan administrator’s name and address
Administrator’s EIN |
203568017 |
Plan administrator’s name |
SUPERMARKET SOURCE INC |
Plan administrator’s
address |
2500 W 84TH ST, SUITE 3, HIALEAH, FL, 33016 |
Administrator’s telephone number |
3058274700 |
Signature of
Role |
Plan administrator |
Date |
2012-07-17 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-17 |
Name of individual signing |
REINALDO PENA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|