|
SOUTH LUBES, INC. 401(K) PLAN
|
2014
|
593282425
|
2015-06-29
|
SOUTH LUBES, INC.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1995-10-01
|
| Business code |
811190
|
| Sponsor’s telephone number |
9042763598
|
| Plan sponsor’s
address |
1890 KINGSLEY AVE STE 104, ORANGE PARK, FL, 320734455
|
Plan administrator’s name and address
| Administrator’s EIN |
621874769 |
| Plan administrator’s name |
TAG RESOURCES, LLC |
| Plan administrator’s
address |
6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2015-06-29 |
| Name of individual signing |
PHIL TISUE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FINAL - SOUTH LUBES, INC. 401(K) PLAN
|
2013
|
593282425
|
2014-08-01
|
SOUTH LUBES, INC.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1995-10-01
|
| Business code |
811190
|
| Sponsor’s telephone number |
9042763598
|
| Plan sponsor’s
address |
1890 KINGSLEY AVE STE 104, ORANGE PARK, FL, 320734455
|
Plan administrator’s name and address
| Administrator’s EIN |
621874769 |
| Plan administrator’s name |
TAG RESOURCES, LLC |
| Plan administrator’s
address |
6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2014-08-01 |
| Name of individual signing |
PHIL TISUE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SOUTH LUBES, INC. 401(K) PLAN
|
2013
|
593282425
|
2014-07-24
|
SOUTH LUBES, INC.
|
65
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1995-10-01
|
| Business code |
811190
|
| Sponsor’s telephone number |
9042763598
|
| Plan sponsor’s
address |
1890 KINGSLEY AVE STE 104, ORANGE PARK, FL, 320734455
|
Plan administrator’s name and address
| Administrator’s EIN |
621874769 |
| Plan administrator’s name |
TAG RESOURCES, LLC |
| Plan administrator’s
address |
6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number |
8656701844 |
Signature of
| Role |
Plan administrator |
| Date |
2014-07-24 |
| Name of individual signing |
PHIL TISUE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SOUTH LUBES, INC. 401(K) PLAN
|
2012
|
593282425
|
2013-09-25
|
SOUTH LUBES, INC.
|
94
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1995-10-01
|
| Business code |
811190
|
| Sponsor’s telephone number |
9042763598
|
| Plan sponsor’s
address |
1890 KINGSLEY AVE STE 104, ORANGE PARK, FL, 320734455
|
Signature of
| Role |
Plan administrator |
| Date |
2013-09-25 |
| Name of individual signing |
JEFF GRANT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-09-25 |
| Name of individual signing |
JEFF GRANT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
