SHORES INSURANCE AGENCY 401(K) PLAN
|
2017
|
650885146
|
2018-06-19
|
SHORES INSURANCE AGENCY
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
524210
|
Plan
sponsor’s DBA name |
SHORES INSURANCE AGENCY
|
Plan sponsor’s
address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 331383341
|
Signature of
Role |
Plan administrator |
Date |
2018-06-19 |
Name of individual signing |
DOUGLAS EATON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORES INSURANCE AGENCY 401K(K) PLAN
|
2016
|
650885146
|
2017-05-01
|
SHORES INSURANCE AGENCY
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3057540002
|
Plan
sponsor’s DBA name |
SHORES INSURANCE AGENCY
|
Plan sponsor’s
address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 331383341
|
Signature of
Role |
Plan administrator |
Date |
2017-04-28 |
Name of individual signing |
DOUGLAS EATON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORES INSURANCE AGENCY 401K(K) PLAN
|
2015
|
650885146
|
2016-07-14
|
SHORES INSURANCE AGENCY
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3057540002
|
Plan
sponsor’s DBA name |
SHORES INSURANCE AGENCY
|
Plan sponsor’s
address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 331383341
|
Plan administrator’s name and address
Administrator’s EIN |
264813020 |
Plan administrator’s name |
EATON FINANCIAL GROUP |
Plan administrator’s
address |
3111 N UNIVERSITY DR STE 404, CORAL SPRINGS, FL, 330655059 |
Administrator’s telephone number |
9545759323 |
Signature of
Role |
Plan administrator |
Date |
2016-07-14 |
Name of individual signing |
DOUGLAS EATON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORES INSURANCE AGENCY 401(K) PLAN
|
2014
|
650885146
|
2015-06-03
|
SHORES INSURANCE AGENCY
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3057540002
|
Plan
sponsor’s DBA name |
SHORES INSURANCE AGENCY
|
Plan sponsor’s
address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 33138
|
Plan administrator’s name and address
Administrator’s EIN |
264813020 |
Plan administrator’s name |
EATON FINANCIAL GROUP |
Plan administrator’s
address |
3111 NORTH UNIVERSITY DRIVE, SUITE 404, CORAL SPRINGS, FL, 33065 |
Administrator’s telephone number |
9545759323 |
Signature of
Role |
Plan administrator |
Date |
2015-06-03 |
Name of individual signing |
DOUGLAS EATON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORES INSURANCE AGENCY 401(K) PLAN
|
2013
|
650885146
|
2014-10-29
|
SHORES INSURANCE AGENCY
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3057540002
|
Plan sponsor’s
address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 33138
|
Plan administrator’s name and address
Administrator’s EIN |
264813020 |
Plan administrator’s name |
EATON FINANCIAL GROUP |
Plan administrator’s
address |
3111 N UNIVERSITY DRIVE, CORAL SPRINGS, FL, 33065 |
Administrator’s telephone number |
9545759323 |
Signature of
Role |
Plan administrator |
Date |
2014-10-29 |
Name of individual signing |
DOUGLAS EATON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORES INSURANCE AGENCY 401(K) PLAN
|
2012
|
650885146
|
2014-10-29
|
SHORES INSURANCE AGENCY
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3057540002
|
Plan sponsor’s
address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 33138
|
Plan administrator’s name and address
Administrator’s EIN |
264813020 |
Plan administrator’s name |
EATON FINANCIAL GROUP |
Plan administrator’s
address |
3111 N UNIVERSITY DRIVE, SUITE 404, CORAL SPRINGS, FL, 33065 |
Administrator’s telephone number |
9545759323 |
Signature of
Role |
Plan administrator |
Date |
2014-10-29 |
Name of individual signing |
DOUGLAS EATON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIAMI SHORES AGENCY
|
2011
|
650885146
|
2012-07-31
|
SHORES INSURANCE AGENCY
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3057540002
|
Plan sponsor’s mailing address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 33138
|
Plan sponsor’s
address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 33138
|
Plan administrator’s name and address
Administrator’s EIN |
262115113 |
Plan administrator’s name |
WILLIAM BAXTER |
Plan administrator’s
address |
15940 MEADOW WOOD DR, WELLINGTON, FL, 33414 |
Administrator’s telephone number |
5613520779 |
Number of participants as of the end of the plan year
Active participants |
3 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
3 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-31 |
Name of individual signing |
WILLIAM BAXTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORES INSURANCE AGENCY
|
2010
|
650885146
|
2011-08-19
|
SHORES INSURANCE AGENCY
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3057540002
|
Plan sponsor’s mailing address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 33138
|
Plan sponsor’s
address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 33138
|
Plan administrator’s name and address
Administrator’s EIN |
262115113 |
Plan administrator’s name |
WILLIAM BAXTER |
Plan administrator’s
address |
15940 MEADOW WOOD DR, WELLINGTON, FL, 33414 |
Administrator’s telephone number |
5613520779 |
Number of participants as of the end of the plan year
Active participants |
3 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
3 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-08-19 |
Name of individual signing |
WILLIAM BAXTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORES INSURANCE AGENCY
|
2009
|
650885146
|
2010-08-01
|
SHORES INSURANCE AGENCY
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3057540002
|
Plan sponsor’s mailing address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 33138
|
Plan sponsor’s
address |
8703 BISCAYNE BLVD, MIAMI SHORES, FL, 33138
|
Plan administrator’s name and address
Administrator’s EIN |
262115113 |
Plan administrator’s name |
WILLIAM BAXTER |
Plan administrator’s
address |
15940 MEADOW WOOD DR., WELLINGTON, FL, 33414 |
Administrator’s telephone number |
5613520779 |
Number of participants as of the end of the plan year
Active participants |
3 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
3 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-08-01 |
Name of individual signing |
WILLIAM BAXTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|