|
STUART A. BAINE, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2012
|
650482492
|
2013-03-15
|
STUART A. BAINE, M.D., P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5619978788
|
| Plan sponsor’s
address |
10351 TRIANON PLACE, WELLINGTON, FL, 33449
|
Plan administrator’s name and address
| Administrator’s EIN |
650482492 |
| Plan administrator’s name |
STUART A. BAINE, M.D., P.A. |
| Plan administrator’s
address |
10351 TRIANON PLACE, WELLINGTON, FL, 33449 |
| Administrator’s telephone number |
5619978788 |
Signature of
| Role |
Plan administrator |
| Date |
2013-03-15 |
| Name of individual signing |
STUART A. BAINE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
STUART A. BAINE, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2011
|
650482492
|
2012-07-28
|
STUART A. BAINE, M.D., P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5614950990
|
| Plan sponsor’s
address |
5258 LINTON BOULEVARD, SUITE 106, DELRAY BEACH, FL, 33484
|
Plan administrator’s name and address
| Administrator’s EIN |
650482492 |
| Plan administrator’s name |
STUART A. BAINE, M.D., P.A. |
| Plan administrator’s
address |
5258 LINTON BOULEVARD, SUITE 106, DELRAY BEACH, FL, 33484 |
| Administrator’s telephone number |
5614950990 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-28 |
| Name of individual signing |
STUART A. BAINE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
STUART A. BAINE, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2010
|
650482492
|
2011-09-16
|
STUART A. BAINE, M.D., P.A.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5614950990
|
| Plan sponsor’s
address |
5258 LINTON BOULEVARD, SUITE 106, DELRAY BEACH, FL, 33484
|
Plan administrator’s name and address
| Administrator’s EIN |
650482492 |
| Plan administrator’s name |
STUART A. BAINE, M.D., P.A. |
| Plan administrator’s
address |
5258 LINTON BOULEVARD, SUITE 106, DELRAY BEACH, FL, 33484 |
| Administrator’s telephone number |
5614950990 |
Signature of
| Role |
Plan administrator |
| Date |
2011-09-16 |
| Name of individual signing |
STUART BAINE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
STUART A. BAINE, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2009
|
650482492
|
2010-09-15
|
STUART A. BAINE, M.D., P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-06-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5614950990
|
| Plan sponsor’s
address |
5258 LINTON BOULEVARD, SUITE 106, DELRAY BEACH, FL, 33484
|
Plan administrator’s name and address
| Administrator’s EIN |
650482492 |
| Plan administrator’s name |
STUART A. BAINE, M.D., P.A. |
| Plan administrator’s
address |
5258 LINTON BOULEVARD, SUITE 106, DELRAY BEACH, FL, 33484 |
| Administrator’s telephone number |
5614950990 |
Signature of
| Role |
Plan administrator |
| Date |
2010-09-14 |
| Name of individual signing |
ANNETTE BAINE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
