SMART PHARMACY, INC WELFARE BENEFIT PLAN
|
2019
|
711012955
|
2021-05-28
|
SMART PHARMACY, INC
|
142
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
8778116337
|
Plan sponsor’s mailing address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Plan sponsor’s
address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-05-27 |
Name of individual signing |
SARAH FIX |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SMART PHARMACY, INC WELFARE BENEFIT PLAN
|
2018
|
711012955
|
2020-05-21
|
SMART PHARMACY, INC
|
141
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2018-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
8778116337
|
Plan sponsor’s mailing address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Plan sponsor’s
address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-05-21 |
Name of individual signing |
SARAH FIX |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SMART PHARMACY, INC WELFARE BENEFIT PLAN
|
2017
|
711012955
|
2019-05-17
|
SMART PHARMACY, INC
|
139
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2017-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
8778116337
|
Plan sponsor’s mailing address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Plan sponsor’s
address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-05-17 |
Name of individual signing |
SARAH FIX |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SMART PHARMACY, INC WELFARE BENEFIT PLAN
|
2016
|
711012955
|
2018-04-23
|
SMART PHARMACY, INC
|
162
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
8778116337
|
Plan sponsor’s mailing address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Plan sponsor’s
address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-04-23 |
Name of individual signing |
SARAH FIX |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-04-23 |
Name of individual signing |
SARAH FIX |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SMART PHARMACY INC 401 K PROFIT SHARING PLAN TRUST
|
2015
|
711012955
|
2016-07-21
|
SMART PHARMACY INC
|
83
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-01-01
|
Business code |
446110
|
Sponsor’s telephone number |
9045035027
|
Plan sponsor’s
address |
14003 BEACH BLVD #1, JACKSONVILLE, FL, 32250
|
Signature of
Role |
Plan administrator |
Date |
2016-07-21 |
Name of individual signing |
LESLIE WILLIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SMART PHARMACY, INC. WELFARE BENEFIT PLAN ANCILLARY BENEFITS
|
2015
|
711012955
|
2017-03-22
|
SMART PHARMACY, INC
|
131
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-10-01
|
Business code |
446110
|
Sponsor’s telephone number |
8778116337
|
Plan sponsor’s mailing address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Plan sponsor’s
address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2017-03-22 |
Name of individual signing |
LESLIE WILLIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SMART PHARMACY, INC. WELFARE BENEFIT PLAN ANCILLARY BENEFITS
|
2015
|
711012955
|
2017-03-22
|
SMART PHARMACY, INC
|
131
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-10-01
|
Business code |
446110
|
Sponsor’s telephone number |
8778116337
|
Plan sponsor’s mailing address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Plan sponsor’s
address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-03-22 |
Name of individual signing |
LESLIE WILLIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-03-22 |
Name of individual signing |
LESLIE WILLIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SMART PHARMACY, INC WELFARE BENEFIT PLAN
|
2015
|
711012955
|
2017-03-22
|
SMART PHARMACY, INC
|
131
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
8778116337
|
Plan sponsor’s mailing address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Plan sponsor’s
address |
3740 ST JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242651
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-03-22 |
Name of individual signing |
LESLIE WILLIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-03-22 |
Name of individual signing |
LESLIE WILLIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SMART PHARMACY INC 401 K PROFIT SHARING PLAN TRUST
|
2014
|
711012955
|
2015-07-24
|
SMART PHARMACY INC
|
37
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
9045035027
|
Plan sponsor’s
address |
14003 BEACH BLVD # 1, JACKSONVILLE BEACH, FL, 322501541
|
Signature of
Role |
Plan administrator |
Date |
2015-07-24 |
Name of individual signing |
DEBBIE PRADO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SMART PHARMACY INC 401 K PROFIT SHARING PLAN TRUST
|
2013
|
711012955
|
2014-07-28
|
SMART PHARMACY INC
|
27
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2013-01-01
|
Business code |
812990
|
Sponsor’s telephone number |
9042218686
|
Plan sponsor’s
address |
1650 SAN PABLO ROAD SOUTH #17, JACKSONVILLE, FL, 32224
|
Signature of
Role |
Plan administrator |
Date |
2014-07-28 |
Name of individual signing |
WILLIAM SCROGINS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|