|
SCOTT MIDDLETON, DMD, MD, P. A. 401(K) PROFIT SHARING PLAN AND TRUST
|
2022
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272914689
|
2023-10-16
|
SCOTT MIDDLETON, DMD, MD, P.A.
|
14
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2015-09-10
|
| Business code |
541990
|
| Sponsor’s telephone number |
9419269100
|
| Plan sponsor’s
address |
2902 BEE RIDGE ROAD, SARASOTA, FL, 34239
|
Signature of
| Role |
Plan administrator |
| Date |
2023-10-16 |
| Name of individual signing |
SCOTT MIDDLETON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SCOTT MIDDLETON, DMD, MD, P. A. 401(K) PROFIT SHARING PLAN AND TRUST
|
2021
|
272914689
|
2022-10-12
|
SCOTT MIDDLETON, DMD, MD, P.A.
|
13
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2015-09-10
|
| Business code |
541990
|
| Sponsor’s telephone number |
9419269100
|
| Plan sponsor’s
address |
2902 BEE RIDGE ROAD, SARASOTA, FL, 34239
|
Signature of
| Role |
Plan administrator |
| Date |
2022-10-12 |
| Name of individual signing |
JESSICA WALSH-MIDDLETON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SCOTT MIDDLETON, INC. DEFINED BENEFIT PENSION PLAN
|
2017
|
272914689
|
2019-04-01
|
SCOTT MIDDLETON, DMD, MD, P.A.
|
12
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|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9419269100
|
| Plan sponsor’s
address |
2902 BEE RIDGE ROAD, SARASOTA, FL, 34239
|
|
|
SCOTT MIDDLETON, INC. DEFINED BENEFIT PENSION PLAN
|
2016
|
272914689
|
2018-01-31
|
SCOTT MIDDLETON, DMD, MD, P.A.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9419269100
|
| Plan sponsor’s
address |
2902 BEE RIDGE ROAD, SARASOTA, FL, 34239
|
|
|
SCOTT MIDDLETON, INC. DEFINED BENEFIT PENSION PLAN
|
2015
|
272914689
|
2016-10-17
|
SCOTT MIDDLETON, DMD, MD, P.A.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9419269100
|
| Plan sponsor’s
address |
2902 BEE RIDGE ROAD, SARASOTA, FL, 34239
|
Signature of
| Role |
Plan administrator |
| Date |
2016-10-17 |
| Name of individual signing |
STEVE OLSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SCOTT MIDDLETON, INC. DEFINED BENEFIT PENSION PLA
|
2014
|
272914689
|
2015-10-14
|
SCOTT MIDDLETON, DMD, MD, P.A.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
9419269100
|
| Plan sponsor’s
address |
2902 BEE RIDGE ROAD, SARASOTA, FL, 34239
|
Signature of
| Role |
Plan administrator |
| Date |
2015-10-14 |
| Name of individual signing |
SCOTT A. MIDDLETON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
