|
LIAN JEN, D.O., P.A. 401(K) PLAN & TRUST
|
2022
|
593574791
|
2023-07-05
|
LIAN JEN, D.O., P.A.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2005-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416279768
|
| Plan sponsor’s
address |
3089 TAMIAMI TRAIL, UNIT B, PORT CHARLOTTE, FL, 339528052
|
Signature of
| Role |
Plan administrator |
| Date |
2023-07-05 |
| Name of individual signing |
LIAN C. JEN, D.O. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LIAN JEN, D.O., P.A. 401(K) PLAN & TRUST
|
2021
|
593574791
|
2023-01-27
|
LIAN JEN, D.O., P.A.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2005-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416279768
|
| Plan sponsor’s
address |
3089 TAMIAMI TRAIL, UNIT B, PORT CHARLOTTE, FL, 339528052
|
Signature of
| Role |
Plan administrator |
| Date |
2023-01-27 |
| Name of individual signing |
LIAN C. JEN, D.O. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LIAN JEN, D.O., P.A. 401(K) PLAN & TRUST
|
2020
|
593574791
|
2021-09-13
|
LIAN JEN, D.O., P.A.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2005-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416279768
|
| Plan sponsor’s
address |
3089 TAMIAMI TRAIL, UNIT B, PORT CHARLOTTE, FL, 339528052
|
Signature of
| Role |
Plan administrator |
| Date |
2021-09-13 |
| Name of individual signing |
LIAN C. JEN, D.O. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LIAN JEN, D.O., P.A. 401(K) PLAN & TRUST
|
2019
|
593574791
|
2020-10-06
|
LIAN JEN, D.O., P.A.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2005-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416279768
|
| Plan sponsor’s
address |
3089 TAMIAMI TRAIL, UNIT B, PORT CHARLOTTE, FL, 339528052
|
Signature of
| Role |
Plan administrator |
| Date |
2020-10-06 |
| Name of individual signing |
LIAN C. JEN, D.O. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LIAN JEN, D.O., P.A. 401(K) PLAN & TRUST
|
2018
|
593574791
|
2019-09-30
|
LIAN JEN, D.O., P.A.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2005-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9416279768
|
| Plan sponsor’s
address |
3089 TAMIAMI TRAIL, UNIT B, PORT CHARLOTTE, FL, 339528052
|
Signature of
| Role |
Plan administrator |
| Date |
2019-09-30 |
| Name of individual signing |
LIAN C. JEN, D.O. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
