|
LACOSTE VISION INC., PROFIT SHARING PLAN
|
2018
|
061832251
|
2019-11-20
|
LACOSTE VISION, INC.
|
1
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-03-11
|
| Business code |
443142
|
| Sponsor’s telephone number |
8507258991
|
| Plan sponsor’s
address |
503B N NAVY BLVD, PENSACOLA, FL, 325072011
|
Signature of
| Role |
Plan administrator |
| Date |
2019-11-20 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2019-11-20 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LACOSTE VISION INC., PROFIT SHARING PLAN
|
2018
|
061832251
|
2019-12-11
|
LACOSTE VISION, INC.
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-03-11
|
| Business code |
443142
|
| Sponsor’s telephone number |
8507258991
|
| Plan sponsor’s
address |
503B N NAVY BLVD, PENSACOLA, FL, 325072011
|
Signature of
| Role |
Plan administrator |
| Date |
2019-12-11 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2019-12-11 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LACOSTE VISION INC., PROFIT SHARING PLAN
|
2017
|
061832251
|
2018-09-17
|
LACOSTE VISION INC.
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-03-11
|
| Business code |
443142
|
| Sponsor’s telephone number |
8507258991
|
| Plan sponsor’s mailing address |
503B N NAVY BLVD, PENSACOLA, FL, 325072011
|
| Plan sponsor’s
address |
503B N NAVY BLVD, PENSACOLA, FL, 325072011
|
Number of participants as of the end of the plan year
| Active participants |
1 |
| Number of
participants
with
account balances as of the end of the plan year |
1 |
Signature of
| Role |
Plan administrator |
| Date |
2018-09-17 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2018-09-17 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LACOSTE VISION, INC. PROFIT SHARING PLAN
|
2015
|
061832251
|
2016-09-06
|
LACOSTE VISION, INC.
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-03-11
|
| Business code |
443142
|
| Sponsor’s telephone number |
8507258991
|
| Plan sponsor’s mailing address |
503B N NAVY BLVD, PENSACOLA, FL, 32507
|
| Plan sponsor’s
address |
503B N NAVY BLVD, PENSACOLA, FL, 32507
|
Number of participants as of the end of the plan year
| Active participants |
1 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
1 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2016-09-06 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LACOSTE VISION, INC. PROFIT SHARING PLAN
|
2014
|
061832251
|
2016-09-06
|
LACOSTE VISION, INC.
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-03-11
|
| Business code |
443142
|
| Sponsor’s telephone number |
8507258991
|
| Plan sponsor’s mailing address |
503B N NAVY BLVD, PENSACOLA, FL, 32507
|
| Plan sponsor’s
address |
503B N NAVY BLVD, PENSACOLA, FL, 32507
|
Number of participants as of the end of the plan year
| Active participants |
1 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
1 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2016-09-06 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LACOSTE VISION, INC. PROFIT SHARING PLAN
|
2014
|
061832251
|
2016-05-18
|
LACOSTE VISION, INC.
|
1
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-03-11
|
| Business code |
443142
|
| Sponsor’s telephone number |
8507258991
|
| Plan sponsor’s mailing address |
503B N NAVY BLVD, PENSACOLA, FL, 32507
|
| Plan sponsor’s
address |
503B N NAVY BLVD, PENSACOLA, FL, 32507
|
Number of participants as of the end of the plan year
| Active participants |
1 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
1 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2016-05-18 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2016-05-18 |
| Name of individual signing |
JERRY LACOSTE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
