|
CUSTOM ANESTHESIA SERVICES, INC. PROFIT SHARING PLAN
|
2014
|
650586710
|
2015-07-17
|
CUSTOM ANESTHESIA SERVICES, INC.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2395437209
|
| Plan sponsor’s mailing address |
15342 BRIAR RIDGE CIRCLE, FORT MYERS, FL, 33912
|
| Plan sponsor’s
address |
15342 BRIAR RIDGE CIRCLE, FT. MYERS, FL, 33912
|
Number of participants as of the end of the plan year
| Active participants |
4 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
4 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2015-07-17 |
| Name of individual signing |
DAVID OBRIEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CUSTOM ANESTHESIA SERVICES, INC. PROFIT SHARING PLAN
|
2013
|
650586710
|
2014-08-13
|
CUSTOM ANESTHESIA SERVICES, INC.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2395437209
|
| Plan sponsor’s mailing address |
15342 BRIAR RIDGE CIRCLE, FORT MYERS, FL, 33912
|
| Plan sponsor’s
address |
15342 BRIAR RIDGE CIRCLE, FT. MYERS, FL, 33912
|
Number of participants as of the end of the plan year
| Active participants |
4 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
4 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2014-08-13 |
| Name of individual signing |
DAVID OBRIEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CUSTOM ANESTHESIA SERVICES, INC. PROFIT SHARING PLAN
|
2012
|
650586710
|
2013-09-04
|
CUSTOM ANESTHESIA SERVICES, INC.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2395437209
|
| Plan sponsor’s mailing address |
15342 BRIAR RIDGE CIRCLE, FORT MYERS, FL, 33912
|
| Plan sponsor’s
address |
15342 BRIAR RIDGE CIRCLE, FT. MYERS, FL, 33912
|
Number of participants as of the end of the plan year
| Active participants |
4 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
4 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2013-09-04 |
| Name of individual signing |
DAVID OBRIEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CUSTOM ANESTHESIA SERVICES, INC. PROFIT SHARING PLAN
|
2011
|
650586710
|
2012-08-13
|
CUSTOM ANESTHESIA SERVICES, INC.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2395437209
|
| Plan sponsor’s mailing address |
15342 BRIAR RIDGE CIRCLE, FORT MYERS, FL, 33912
|
| Plan sponsor’s
address |
15342 BRIAR RIDGE CIRCLE, FT. MYERS, FL, 33912
|
Plan administrator’s name and address
| Administrator’s EIN |
650586710 |
| Plan administrator’s name |
CUSTOM ANESTHESIA SERVICES, INC. |
| Plan administrator’s
address |
15342 BRIAR RIDGE CIRCLE, FORT MYERS, FL, 33912 |
| Administrator’s telephone number |
2395437209 |
Number of participants as of the end of the plan year
| Active participants |
4 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
4 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2012-08-10 |
| Name of individual signing |
DAVID OBRIEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CUSTOM ANESTHESIA SERVICES, INC. PROFIT SHARING PLAN
|
2010
|
650586710
|
2011-06-02
|
CUSTOM ANESTHESIA SERVICES, INC.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2395437209
|
| Plan sponsor’s mailing address |
15342 BRIAR RIDGE CIRCLE, FORT MYERS, FL, 33912
|
| Plan sponsor’s
address |
15342 BRIAR RIDGE CIRCLE, FT. MYERS, FL, 33912
|
Plan administrator’s name and address
| Administrator’s EIN |
650586710 |
| Plan administrator’s name |
CUSTOM ANESTHESIA SERVICES, INC. |
| Plan administrator’s
address |
15342 BRIAR RIDGE CIRCLE, FORT MYERS, FL, 33912 |
| Administrator’s telephone number |
2395437209 |
Number of participants as of the end of the plan year
| Active participants |
4 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
4 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-06-01 |
| Name of individual signing |
DAVID OBRIEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CUSTOM ANESTHESIA SERVICES, INC. PROFIT SHARING PLAN
|
2009
|
650586710
|
2010-09-20
|
CUSTOM ANESTHESIA SERVICES, INC.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1999-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
2395437209
|
| Plan sponsor’s mailing address |
15342 BRIAR RIDGE CIRCLE, FORT MYERS, FL, 33912
|
| Plan sponsor’s
address |
15342 BRIAR RIDGE CIRCLE, FT. MYERS, FL, 33912
|
Plan administrator’s name and address
| Administrator’s EIN |
650586710 |
| Plan administrator’s name |
CUSTOM ANESTHESIA SERVICES, INC. |
| Plan administrator’s
address |
15342 BRIAR RIDGE CIRCLE, FORT MYERS, FL, 33912 |
| Administrator’s telephone number |
2395437209 |
Number of participants as of the end of the plan year
| Active participants |
4 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
4 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-09-20 |
| Name of individual signing |
DAVID OBRIEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
