WILLIAM I ROTH, M.D., P.A. PROFIT SHARING PLAN
|
2016
|
650657207
|
2017-03-30
|
WILLIAM I ROTH, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
6301 GRAYCLIFF DRIVE, APT. B, BOCA RATON, FL, 33496
|
Signature of
Role |
Plan administrator |
Date |
2017-03-30 |
Name of individual signing |
WILLIAM I. ROTH, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM I. ROTH, M.D., P.A. DEFINED BENEFIT PLAN
|
2016
|
650657207
|
2017-05-16
|
WILLIAM I. ROTH, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
6301 GRAYCLIFF DR., APT. B, BOCA RATON, FL, 33496
|
Signature of
Role |
Plan administrator |
Date |
2017-05-16 |
Name of individual signing |
WILLIAM I. ROTH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM I ROTH, M.D., P.A. PROFIT SHARING PLAN
|
2015
|
650657207
|
2016-03-31
|
WILLIAM I ROTH, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
10075 JOG ROAD, SUITE 206, BOYNTON BEACH, FL, 33437
|
Signature of
Role |
Plan administrator |
Date |
2016-03-31 |
Name of individual signing |
WILLIAM I. ROTH, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM I. ROTH, M.D., P.A. DEFINED BENEFIT PLAN
|
2015
|
650657207
|
2016-05-04
|
WILLIAM I. ROTH, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
6301 GRAYCLIFF DR., APT. B, BOCA RATON, FL, 33496
|
Signature of
Role |
Plan administrator |
Date |
2016-05-04 |
Name of individual signing |
WILLIAM I. ROTH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM I ROTH, M.D., P.A. PROFIT SHARING PLAN
|
2014
|
650657207
|
2015-05-08
|
WILLIAM I ROTH, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
6348 NW 30TH AVENUE, BOCA RATON, FL, 33496
|
Signature of
Role |
Plan administrator |
Date |
2015-05-08 |
Name of individual signing |
WILLIAM I. ROTH, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM I. ROTH, M.D., P.A. DEFINED BENEFIT PLAN
|
2014
|
650657207
|
2015-06-23
|
WILLIAM I. ROTH, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
6348 NW 30TH AVE, BOCA RATON, FL, 33496
|
Signature of
Role |
Plan administrator |
Date |
2015-06-23 |
Name of individual signing |
WILLIAM I. ROTH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM I. ROTH, M.D., P.A. DEFINED BENEFIT PLAN
|
2013
|
650657207
|
2014-07-16
|
WILLIAM I. ROTH, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
6348 NW 30TH AVE, BOCA RATON, FL, 33496
|
Signature of
Role |
Plan administrator |
Date |
2014-07-16 |
Name of individual signing |
CAMERON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM I ROTH, M.D., P.A. PROFIT SHARING PLAN
|
2013
|
650657207
|
2014-06-25
|
WILLIAM I ROTH, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
6348 NW 30TH AVENUE, BOCA RATON, FL, 33496
|
Signature of
Role |
Plan administrator |
Date |
2014-06-25 |
Name of individual signing |
REBECCA TORRES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM I. ROTH, M.D., P.A. DEFINED BENEFIT PLAN
|
2012
|
650657207
|
2013-05-06
|
WILLIAM I. ROTH, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
6348 NW 30TH AVE, BOCA RATON, FL, 33496
|
Signature of
Role |
Plan administrator |
Date |
2013-05-06 |
Name of individual signing |
CAMERON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM I ROTH, M.D., P.A. PROFIT SHARING PLAN
|
2012
|
650657207
|
2013-05-13
|
WILLIAM I ROTH, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5617314900
|
Plan sponsor’s
address |
6348 NW 30TH AVENUE, BOCA RATON, FL, 33496
|
Signature of
Role |
Plan administrator |
Date |
2013-05-13 |
Name of individual signing |
CAMERON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|