REX L. GOMEZ, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2017
|
593385088
|
2018-05-08
|
REX L. GOMEZ, M.D, P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3216900002
|
Plan sponsor’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955
|
Signature of
Role |
Plan administrator |
Date |
2018-05-08 |
Name of individual signing |
REX GOMEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
REX L. GOMEZ, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2016
|
593385088
|
2017-06-12
|
REX L. GOMEZ, M.D, P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3216900002
|
Plan sponsor’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955
|
Signature of
Role |
Plan administrator |
Date |
2017-06-12 |
Name of individual signing |
REX GOMEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
REX L. GOMEZ, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2015
|
593385088
|
2016-09-08
|
REX L. GOMEZ, M.D, P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3216900002
|
Plan sponsor’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955
|
Signature of
Role |
Plan administrator |
Date |
2016-09-08 |
Name of individual signing |
REX GOMEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
REX L. GOMEZ, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2014
|
593385088
|
2015-09-17
|
REX L. GOMEZ, M.D, P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3216900002
|
Plan sponsor’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955
|
Signature of
Role |
Plan administrator |
Date |
2015-09-17 |
Name of individual signing |
REX GOMEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
REX L. GOMEZ, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2013
|
593385088
|
2014-09-15
|
REX L. GOMEZ, M.D, P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3216900002
|
Plan sponsor’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955
|
Signature of
Role |
Plan administrator |
Date |
2014-09-15 |
Name of individual signing |
REX GOMEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
REX L. GOMEZ, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2012
|
593385088
|
2013-03-21
|
REX L. GOMEZ, M.D, P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3216900002
|
Plan sponsor’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955
|
Plan administrator’s name and address
Administrator’s EIN |
593385088 |
Plan administrator’s name |
REX L. GOMEZ, M.D, P.A. |
Plan administrator’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955 |
Administrator’s telephone number |
3216900002 |
Signature of
Role |
Plan administrator |
Date |
2013-03-21 |
Name of individual signing |
REX GOMEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
REX L. GOMEZ, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2011
|
593385088
|
2012-06-12
|
REX L. GOMEZ, M.D, P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3216900002
|
Plan sponsor’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955
|
Plan administrator’s name and address
Administrator’s EIN |
593385088 |
Plan administrator’s name |
REX L. GOMEZ, M.D, P.A. |
Plan administrator’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955 |
Administrator’s telephone number |
3216900002 |
Signature of
Role |
Plan administrator |
Date |
2012-06-12 |
Name of individual signing |
REX GOMEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
REX L. GOMEZ, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2010
|
593385088
|
2011-10-06
|
REX L. GOMEZ, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3216900002
|
Plan sponsor’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955
|
Plan administrator’s name and address
Administrator’s EIN |
593385088 |
Plan administrator’s name |
REX L. GOMEZ, M.D., P.A. |
Plan administrator’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955 |
Administrator’s telephone number |
3216900002 |
Signature of
Role |
Plan administrator |
Date |
2011-10-05 |
Name of individual signing |
REX GOMEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
REX L. GOMEZ, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2009
|
593385088
|
2010-06-24
|
REX L. GOMEZ, M.D, P.A.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3216900002
|
Plan sponsor’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955
|
Plan administrator’s name and address
Administrator’s EIN |
593385088 |
Plan administrator’s name |
REX L. GOMEZ, M.D, P.A. |
Plan administrator’s
address |
1273 FLORIDA AVENUE S, ROCKLEDGE, FL, 32955 |
Administrator’s telephone number |
3216900002 |
Signature of
Role |
Plan administrator |
Date |
2010-06-24 |
Name of individual signing |
REX GOMEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|