RETINA CARE SPECIALISTS DEFINED BENEFIT PENSION PLAN & TRUST
|
2013
|
650893335
|
2014-09-26
|
MARK MICHELS, M.D., P.A.
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2003-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5616240099
|
Plan sponsor’s
address |
3399 PGA BLVD., SUITE 350, PALM BEACH GARDENS, FL, 33410
|
Plan administrator’s name and address
Administrator’s EIN |
650893335 |
Plan administrator’s name |
MARK MICHELS, M.D., P.A. |
Plan administrator’s
address |
3399 PGA BLVD., SUITE 350, PALM BEACH GARDENS, FL, 33410 |
Administrator’s telephone number |
5616240099 |
Signature of
Role |
Plan administrator |
Date |
2014-09-26 |
Name of individual signing |
MARK MICHELS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RETINA CARE SPECIALISTS DEFINED BENEFIT PENSION PLAN & TRUST
|
2012
|
650893335
|
2013-09-23
|
MARK MICHELS, M.D., P.A.
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2003-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5616240099
|
Plan sponsor’s
address |
3399 PGA BLVD., SUITE 350, PALM BEACH GARDENS, FL, 33410
|
Plan administrator’s name and address
Administrator’s EIN |
650893335 |
Plan administrator’s name |
MARK MICHELS, M.D., P.A. |
Plan administrator’s
address |
3399 PGA BLVD., SUITE 350, PALM BEACH GARDENS, FL, 33410 |
Administrator’s telephone number |
5616240099 |
Signature of
Role |
Plan administrator |
Date |
2013-09-23 |
Name of individual signing |
MARK MICHELS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RETINA CARE SPECIALISTS DEFINED BENEFIT PENSION PLAN & TRUST
|
2011
|
650893335
|
2012-10-12
|
MARK MICHELS, M.D., P.A.
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2003-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5616240099
|
Plan sponsor’s
address |
3399 PGA BLVD., SUITE 350, PALM BEACH GARDENS, FL, 33410
|
Plan administrator’s name and address
Administrator’s EIN |
650893335 |
Plan administrator’s name |
MARK MICHELS, M.D., P.A. |
Plan administrator’s
address |
3399 PGA BLVD., SUITE 350, PALM BEACH GARDENS, FL, 33410 |
Administrator’s telephone number |
5616240099 |
Signature of
Role |
Plan administrator |
Date |
2012-10-12 |
Name of individual signing |
MARK MICHELS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RETINA CARE SPECIALISTS DEFINED BENEFIT PENSION PLAN & TRUST
|
2009
|
650893335
|
2010-09-15
|
MARK MICHELS, M.D., P.A.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2003-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
5616240099
|
Plan sponsor’s
address |
3399 PGA BLVD., SUITE 350, PALM BEACH GARDENS, FL, 33410
|
Plan administrator’s name and address
Administrator’s EIN |
650893335 |
Plan administrator’s name |
MARK MICHELS, M.D., P.A. |
Plan administrator’s
address |
3399 PGA BLVD., SUITE 350, PALM BEACH GARDENS, FL, 33410 |
Administrator’s telephone number |
5616240099 |
Signature of
Role |
Plan administrator |
Date |
2010-09-15 |
Name of individual signing |
MARK MICHELS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-09-15 |
Name of individual signing |
MARK MICHELS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|