JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2017
|
593522131
|
2018-05-11
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
485 STATE ROAD 13 NORTH, SUITE 4, ST. JOHNS, FL, 32259
|
Signature of
Role |
Plan administrator |
Date |
2018-05-11 |
Name of individual signing |
SUSAN AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2017
|
593522131
|
2018-12-06
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
485 STATE ROAD 13 NORTH, SUITE 4, ST. JOHNS, FL, 32259
|
Signature of
Role |
Plan administrator |
Date |
2018-12-06 |
Name of individual signing |
SUSAN AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2016
|
593522131
|
2017-06-26
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
485 STATE ROAD 13 NORTH, SUITE 4, ST. JOHNS, FL, 32259
|
Signature of
Role |
Plan administrator |
Date |
2017-06-26 |
Name of individual signing |
SUSAN AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2015
|
593522131
|
2016-06-29
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
485 STATE ROAD 13 NORTH, SUITE 4, ST. JOHNS, FL, 32259
|
Signature of
Role |
Plan administrator |
Date |
2016-06-29 |
Name of individual signing |
SUSAN AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2014
|
593522131
|
2015-06-15
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
485 STATE ROAD 13 NORTH, SUITE 4, ST. JOHNS, FL, 32259
|
Signature of
Role |
Plan administrator |
Date |
2015-06-15 |
Name of individual signing |
SUSAN AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2013
|
593522131
|
2014-06-08
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
485 STATE ROAD 13 NORTH, SUITE 4, ST. JOHNS, FL, 32259
|
Signature of
Role |
Plan administrator |
Date |
2014-06-08 |
Name of individual signing |
SUSAN AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2012
|
593522131
|
2013-04-30
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
485 STATE ROAD 13 NORTH, SUITE 4, ST. JOHNS, FL, 32259
|
Signature of
Role |
Plan administrator |
Date |
2013-04-30 |
Name of individual signing |
SUSAN AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2011
|
593522131
|
2012-06-06
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
485 STATE ROAD 13 NORTH, SUITE 4, ST. JOHNS, FL, 32259
|
Plan administrator’s name and address
Administrator’s EIN |
593522131 |
Plan administrator’s name |
JULINGTON CREEK FAMILY DENTISTRY, P.A. |
Plan administrator’s
address |
485 STATE ROAD 13 NORTH, SUITE 4, ST. JOHNS, FL, 32259 |
Administrator’s telephone number |
9042302961 |
Signature of
Role |
Plan administrator |
Date |
2012-06-06 |
Name of individual signing |
SUSAN L. AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-06-06 |
Name of individual signing |
SUSAN L. AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2010
|
593522131
|
2011-06-12
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
465 STATE ROAD 13 NORTH, SUITE 9, JACKSONVILLE, FL, 32259
|
Plan administrator’s name and address
Administrator’s EIN |
593522131 |
Plan administrator’s name |
JULINGTON CREEK FAMILY DENTISTRY, P.A. |
Plan administrator’s
address |
465 STATE ROAD 13 NORTH, SUITE 9, JACKSONVILLE, FL, 32259 |
Administrator’s telephone number |
9042302961 |
Signature of
Role |
Plan administrator |
Date |
2011-06-12 |
Name of individual signing |
SUSAN L. AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-06-12 |
Name of individual signing |
SUSAN L. AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JULINGTON CREEK FAMILY DENTISTRY, P.A. RETIREMENT PLAN & TRUST
|
2009
|
593522131
|
2010-06-01
|
JULINGTON CREEK FAMILY DENTISTRY, P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
9042302961
|
Plan sponsor’s
address |
465 STATE ROAD 13 NORTH, SUITE 9, JACKSONVILLE, FL, 32259
|
Plan administrator’s name and address
Administrator’s EIN |
593522131 |
Plan administrator’s name |
JULINGTON CREEK FAMILY DENTISTRY, P.A. |
Plan administrator’s
address |
465 STATE ROAD 13 NORTH, SUITE 9, JACKSONVILLE, FL, 32259 |
Administrator’s telephone number |
9042302961 |
Signature of
Role |
Plan administrator |
Date |
2010-06-01 |
Name of individual signing |
SUSAN L. AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-06-01 |
Name of individual signing |
SUSAN L. AMATRUDI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|