EZE D. UCHE, M.D., P.A. 401(K) PROFIT SHARING PLAN AND TRUST
|
2011
|
593506526
|
2012-10-12
|
EZE D. UCHE, M.D., 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 |
3523600058
|
Plan sponsor’s
address |
4646 VIA DEL MEDICO, LEESBURG, FL, 34748
|
Plan administrator’s name and address
Administrator’s EIN |
593506526 |
Plan administrator’s name |
EZE D. UCHE, M.D., P.A. |
Plan administrator’s
address |
4646 VIA DEL MEDICO, LEESBURG, FL, 34748 |
Administrator’s telephone number |
3523600058 |
Signature of
Role |
Plan administrator |
Date |
2012-10-12 |
Name of individual signing |
EZE UCHE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-12 |
Name of individual signing |
EZE UCHE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EZE D. UCHE, M.D., P.A. 401(K) PROFIT SHARING PLAN AND TRUST
|
2010
|
593506526
|
2011-10-12
|
EZE D. UCHE, M.D., P.A.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3523600058
|
Plan sponsor’s
address |
4646 VIA DEL MEDICO, LEESBURG, FL, 34748
|
Plan administrator’s name and address
Administrator’s EIN |
593506526 |
Plan administrator’s name |
EZE D. UCHE, M.D., P.A. |
Plan administrator’s
address |
4646 VIA DEL MEDICO, LEESBURG, FL, 34748 |
Administrator’s telephone number |
3523600058 |
Signature of
Role |
Plan administrator |
Date |
2011-10-12 |
Name of individual signing |
EZE D. UCHE, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-10-12 |
Name of individual signing |
EZE D. UCHE, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EZE D UCHE M D P A
|
2009
|
593506526
|
2010-07-26
|
EZE D UCHE M D 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 |
3523600058
|
Plan sponsor’s
address |
1020 NORTH BLVD EAST, LEESBURG, FL, 34748
|
Plan administrator’s name and address
Administrator’s EIN |
593506526 |
Plan administrator’s name |
EZE D UCHE M D P A |
Plan administrator’s
address |
1020 NORTH BLVD EAST, LEESBURG, FL, 34748 |
Administrator’s telephone number |
3523600058 |
Signature of
Role |
Plan administrator |
Date |
2010-07-26 |
Name of individual signing |
EZE D UCHE M D P A |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EZE D UCHE M D P A
|
2009
|
593506526
|
2010-07-26
|
EZE D UCHE M D P A
|
4
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3523600058
|
Plan sponsor’s
address |
1020 NORTH BLVD EAST, LEESBURG, FL, 34748
|
Plan administrator’s name and address
Administrator’s EIN |
593506526 |
Plan administrator’s name |
EZE D UCHE M D P A |
Plan administrator’s
address |
1020 NORTH BLVD EAST, LEESBURG, FL, 34748 |
Administrator’s telephone number |
3523600058 |
Signature of
Role |
Plan administrator |
Date |
2010-07-26 |
Name of individual signing |
EZE D UCHE M D P A |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
EZE D UCHE M D P A
|
2009
|
593506526
|
2010-07-26
|
EZE D UCHE M D P A
|
4
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3523600058
|
Plan sponsor’s
address |
1020 NORTH BLVD EAST, LEESBURG, FL, 34748
|
Plan administrator’s name and address
Administrator’s EIN |
593506526 |
Plan administrator’s name |
EZE D UCHE M D P A |
Plan administrator’s
address |
1020 NORTH BLVD EAST, LEESBURG, FL, 34748 |
Administrator’s telephone number |
3523600058 |
Signature of
Role |
Plan administrator |
Date |
2010-07-26 |
Name of individual signing |
EZE D UCHE M D P A |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|