|
JEFFREY W. HENSLEY P.A. 401(K) PLAN
|
2011
|
593229394
|
2012-10-11
|
JEFFREY W. HENSLEY P.A.
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
2005-01-01
|
| Business code |
541110
|
| Sponsor’s telephone number |
7277813433
|
| Plan sponsor’s
address |
2600 TAMPA RD, PALM HARBOR, FL, 346843108
|
Plan administrator’s name and address
| Administrator’s EIN |
593229394 |
| Plan administrator’s name |
JEFFREY W. HENSLEY P.A. |
| Plan administrator’s
address |
2600 TAMPA RD, PALM HARBOR, FL, 346843108 |
| Administrator’s telephone number |
7277813433 |
Signature of
| Role |
Plan administrator |
| Date |
2012-10-11 |
| Name of individual signing |
JEFFREY W. HENSLEY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JEFFREY W. HENSLEY P.A. 401(K) PLAN
|
2010
|
593229394
|
2011-10-06
|
JEFFREY W. HENSLEY P.A.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
2005-01-01
|
| Business code |
541110
|
| Sponsor’s telephone number |
7277813433
|
| Plan sponsor’s
address |
2600 TAMPA RD, PALM HARBOR, FL, 346843108
|
Plan administrator’s name and address
| Administrator’s EIN |
593229394 |
| Plan administrator’s name |
JEFFREY W. HENSLEY P.A. |
| Plan administrator’s
address |
2600 TAMPA RD, PALM HARBOR, FL, 346843108 |
| Administrator’s telephone number |
7277813433 |
Signature of
| Role |
Plan administrator |
| Date |
2011-10-06 |
| Name of individual signing |
JEFFREY W. HENSLEY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JEFFREY W. HENSLEY P.A. 401(K) PLAN
|
2009
|
593229394
|
2010-10-07
|
JEFFREY W. HENSLEY P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
2005-01-01
|
| Business code |
541110
|
| Sponsor’s telephone number |
7277813433
|
| Plan sponsor’s
address |
2600 TAMPA RD, PALM HARBOR, FL, 346843108
|
Plan administrator’s name and address
| Administrator’s EIN |
593229394 |
| Plan administrator’s name |
JEFFREY W. HENSLEY P.A. |
| Plan administrator’s
address |
2600 TAMPA RD, PALM HARBOR, FL, 346843108 |
| Administrator’s telephone number |
7277813433 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-07 |
| Name of individual signing |
JEFFREY W. HENSLEY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
