|
CHARLES H. CROFT, M.D., P.A. 401(K) P/S PLAN
|
2023
|
593213651
|
2024-09-20
|
CHARLES H. CROFT, M.D., P.A.
|
18
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
2002-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3217739516
|
| Plan sponsor’s
address |
1402 OAK ST, MELBOURNE, FL, 32901
|
Signature of
| Role |
Plan administrator |
| Date |
2024-07-31 |
| Name of individual signing |
MICHAEL S GEMMELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHARLES H. CROFT, M.D., P.A. 401(K) P/S PLAN
|
2022
|
593213651
|
2023-07-19
|
CHARLES H. CROFT, M.D., P.A.
|
18
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
2002-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3217739516
|
| Plan sponsor’s
address |
1402 OAK ST, MELBOURNE, FL, 32901
|
Plan administrator’s name and address
| Administrator’s EIN |
593213651 |
| Plan administrator’s name |
CHARLES H. CROFT, M.D., P.A. |
| Plan administrator’s
address |
1402 OAK ST, MELBOURNE, FL, 32901 |
| Administrator’s telephone number |
3217739516 |
Signature of
| Role |
Plan administrator |
| Date |
2023-07-19 |
| Name of individual signing |
MICHAEL GEMMELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHARLES H. CROFT, M.D., P.A. 401(K) P/S PLAN
|
2021
|
593213651
|
2022-09-01
|
CHARLES H. CROFT, M.D., P.A.
|
16
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
2002-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3217739516
|
| Plan sponsor’s
address |
1402 OAK ST, MELBOURNE, FL, 32901
|
Plan administrator’s name and address
| Administrator’s EIN |
593213651 |
| Plan administrator’s name |
CHARLES H. CROFT, M.D., P.A. |
| Plan administrator’s
address |
1402 OAK ST, MELBOURNE, FL, 32901 |
| Administrator’s telephone number |
3217739516 |
Signature of
| Role |
Plan administrator |
| Date |
2022-09-01 |
| Name of individual signing |
MICHAEL GEMMELL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHARLES H. CROFT, M.D., P.A. 401(K) P/S PLAN
|
2020
|
593213651
|
2021-09-07
|
CHARLES H. CROFT, M.D., P.A.
|
15
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
2002-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3217739516
|
| Plan sponsor’s
address |
1402 OAK ST, MELBOURNE, FL, 32901
|
Plan administrator’s name and address
| Administrator’s EIN |
593213651 |
| Plan administrator’s name |
CHARLES H. CROFT, M.D., P.A. |
| Plan administrator’s
address |
1402 OAK ST, MELBOURNE, FL, 32901 |
| Administrator’s telephone number |
3217739516 |
Signature of
| Role |
Plan administrator |
| Date |
2021-09-07 |
| Name of individual signing |
CHARLES H CROFT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
