|
BAY UROLOGY PA 401(K) PROFIT SHARING PLAND & TRUST
|
2012
|
651306977
|
2014-11-11
|
BAY UROLOGY PA
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7277984841
|
| Plan sponsor’s
address |
990 CYPRESS COVE WAY, TARPON SPRINGS, FL, 34688
|
Signature of
| Role |
Plan administrator |
| Date |
2014-11-11 |
| Name of individual signing |
MARY JO ARNOLD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2014-11-11 |
| Name of individual signing |
MARY JO ARNOLD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BAY UROLOGY PA 401 K PROFIT SHARING PLAN TRUST
|
2011
|
651306977
|
2012-05-29
|
BAY UROLOGY PA
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7279463446
|
| Plan sponsor’s
address |
990 CYPRESS COVE WAY, TARPON SPRINGS, FL, 346887369
|
Plan administrator’s name and address
| Administrator’s EIN |
651306977 |
| Plan administrator’s name |
BAY UROLOGY PA |
| Plan administrator’s
address |
990 CYPRESS COVE WAY, TARPON SPRINGS, FL, 346887369 |
| Administrator’s telephone number |
7279463446 |
Signature of
| Role |
Plan administrator |
| Date |
2012-05-29 |
| Name of individual signing |
BAY UROLOGY PA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BAY UROLOGY 401(K) PLAN
|
2009
|
651306977
|
2010-10-15
|
BAY UROLOGY, PA
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7274492298
|
| Plan sponsor’s
address |
1840 MEASE DRIVE, SUITE 403A, SAFETY HARBOR, FL, 34695
|
Plan administrator’s name and address
| Administrator’s EIN |
651306977 |
| Plan administrator’s name |
BAY UROLOGY, PA |
| Plan administrator’s
address |
1840 MEASE DRIVE, SUITE 403A, SAFETY HARBOR, FL, 34695 |
| Administrator’s telephone number |
7274492298 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-15 |
| Name of individual signing |
PAUL ARNOLD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
