|
SANTA ROSA DE LIMA MEDICAL, P.A. PROFIT SHARING PLAN
|
2012
|
593400348
|
2013-10-11
|
SANTA ROSA DE LIMA MEDICAL, P.A.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3862280661
|
| Plan sponsor’s
address |
4916 SAN MARINO CIR., LAKE MARY, FL, 327462608
|
Signature of
| Role |
Plan administrator |
| Date |
2013-10-11 |
| Name of individual signing |
KAREN SARNO |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-10-11 |
| Name of individual signing |
KAREN SARNO |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SANTA ROSA DE LIMA MEDICAL, P.A. PROFIT SHARING PLAN
|
2011
|
593400348
|
2012-08-21
|
SANTA ROSA DE LIMA MEDICAL, P.A.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3862280661
|
| Plan sponsor’s
address |
4916 SAN MARINO CIR., LAKE MARY, FL, 327462608
|
Plan administrator’s name and address
| Administrator’s EIN |
593400348 |
| Plan administrator’s name |
SANTA ROSA DE LIMA MEDICAL, P.A. |
| Plan administrator’s
address |
4916 SAN MARINO CIR., LAKE MARY, FL, 327462608 |
| Administrator’s telephone number |
3862280661 |
Signature of
| Role |
Plan administrator |
| Date |
2012-08-21 |
| Name of individual signing |
TATIANA POMBO |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-08-21 |
| Name of individual signing |
TATIANA POMBO |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SANTA ROSA DE LIMA MEDICAL, P.A. PROFIT SHARING PLAN
|
2010
|
593400348
|
2011-08-24
|
SANTA ROSA DE LIMA MEDICAL, P.A.
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3862280661
|
| Plan sponsor’s
address |
4916 SAN MARINO CIR., LAKE MARY, FL, 327462608
|
Plan administrator’s name and address
| Administrator’s EIN |
593400348 |
| Plan administrator’s name |
SANTA ROSA DE LIMA MEDICAL, P.A. |
| Plan administrator’s
address |
4916 SAN MARINO CIR., LAKE MARY, FL, 327462608 |
| Administrator’s telephone number |
3862280661 |
Signature of
| Role |
Plan administrator |
| Date |
2011-08-24 |
| Name of individual signing |
TATIANA CHAVEZ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-08-24 |
| Name of individual signing |
TATIANA CHAVEZ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SANTA ROSA DE LIMA MEDICAL, P.A. PROFIT SHARING PLAN
|
2009
|
593400348
|
2010-09-15
|
SANTA ROSA DE LIMA MEDICAL, P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3862280661
|
| Plan sponsor’s
address |
4916 SAN MARINO CIR., LAKE MARY, FL, 327462608
|
Plan administrator’s name and address
| Administrator’s EIN |
593400348 |
| Plan administrator’s name |
SANTA ROSA DE LIMA MEDICAL, P.A. |
| Plan administrator’s
address |
4916 SAN MARINO CIR., LAKE MARY, FL, 327462608 |
| Administrator’s telephone number |
3862280661 |
Signature of
| Role |
Plan administrator |
| Date |
2010-09-15 |
| Name of individual signing |
JULIE BURGESS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
