PHYSICIAN SERVICES, INC. PROFIT SHARING PLAN
|
2011
|
593557599
|
2012-08-30
|
PHYSICIAN SERVICES, INC.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636798815
|
Plan sponsor’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320
|
Plan administrator’s name and address
Administrator’s EIN |
593557599 |
Plan administrator’s name |
PHYSICIAN SERVICES, INC. |
Plan administrator’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320 |
Administrator’s telephone number |
8636798815 |
Signature of
Role |
Plan administrator |
Date |
2012-08-30 |
Name of individual signing |
KULMEET S. KUNDLAS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN SERVICES, INC. PROFIT SHARING PLAN
|
2011
|
593557599
|
2012-08-30
|
PHYSICIAN SERVICES, INC.
|
12
|
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636798815
|
Plan sponsor’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320
|
Plan administrator’s name and address
Administrator’s EIN |
593557599 |
Plan administrator’s name |
PHYSICIAN SERVICES, INC. |
Plan administrator’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320 |
Administrator’s telephone number |
8636798815 |
Signature of
Role |
Plan administrator |
Date |
2012-08-30 |
Name of individual signing |
KULMEET S. KUNDLAS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN SERVICES, INC. DEFINED BENEFIT PENSION PLAN
|
2011
|
593557599
|
2012-09-05
|
PHYSICIAN SERVICES, INC.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2001-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636798815
|
Plan sponsor’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320
|
Plan administrator’s name and address
Administrator’s EIN |
593557599 |
Plan administrator’s name |
PHYSICIAN SERVICES, INC. |
Plan administrator’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320 |
Administrator’s telephone number |
8636798815 |
Signature of
Role |
Plan administrator |
Date |
2012-09-05 |
Name of individual signing |
KULMEET KUNDLAS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN SERVICES, INC. DEFINED BENEFIT PENSION PLAN
|
2010
|
593557599
|
2011-10-14
|
PHYSICIAN SERVICES, INC.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2001-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636798815
|
Plan sponsor’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320
|
Plan administrator’s name and address
Administrator’s EIN |
593557599 |
Plan administrator’s name |
PHYSICIAN SERVICES, INC. |
Plan administrator’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320 |
Administrator’s telephone number |
8636798815 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
KULMEET KUNDLAS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN SERVICES, INC. PROFIT SHARING PLAN
|
2010
|
593557599
|
2011-10-14
|
PHYSICIAN SERVICES, INC.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636798815
|
Plan sponsor’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320
|
Plan administrator’s name and address
Administrator’s EIN |
593557599 |
Plan administrator’s name |
PHYSICIAN SERVICES, INC. |
Plan administrator’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320 |
Administrator’s telephone number |
8636798815 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
KULMEET S. KUNDLAS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN SERVICES, INC. DEFINED BENEFIT PENSION PLAN
|
2009
|
593557599
|
2010-10-12
|
PHYSICIAN SERVICES, INC.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2001-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636798815
|
Plan sponsor’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320
|
Plan administrator’s name and address
Administrator’s EIN |
593557599 |
Plan administrator’s name |
PHYSICIAN SERVICES, INC. |
Plan administrator’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320 |
Administrator’s telephone number |
8636798815 |
Signature of
Role |
Plan administrator |
Date |
2010-10-12 |
Name of individual signing |
KULMEET KUNDLAS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PHYSICIAN SERVICES, INC. PROFIT SHARING PLAN
|
2009
|
593557599
|
2010-10-11
|
PHYSICIAN SERVICES, INC.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8636798815
|
Plan sponsor’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320
|
Plan administrator’s name and address
Administrator’s EIN |
593557599 |
Plan administrator’s name |
PHYSICIAN SERVICES, INC. |
Plan administrator’s
address |
1143 STATE ROUTE 60 EAST, LAKE WALES, FL, 338534320 |
Administrator’s telephone number |
8636798815 |
Signature of
Role |
Plan administrator |
Date |
2010-10-11 |
Name of individual signing |
KULMEET S. KUNDLAS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|