|
M. SCOTT RUNNELS, D.M.D., P.A. RETIREMENT PLAN AND TRUST
|
2011
|
593594939
|
2012-10-09
|
M. SCOTT RUNNELS, D.M.D., P.A.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8502690333
|
| Plan sponsor’s
address |
4399 COMMONS DRIVE EAST, DESTIN, FL, 32541
|
Plan administrator’s name and address
| Administrator’s EIN |
593594939 |
| Plan administrator’s name |
M. SCOTT RUNNELS, D.M.D., P.A. |
| Plan administrator’s
address |
4399 COMMONS DRIVE EAST, DESTIN, FL, 32541 |
| Administrator’s telephone number |
8502690333 |
Signature of
| Role |
Plan administrator |
| Date |
2012-10-09 |
| Name of individual signing |
M. SCOTT RUNNELS, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
M. SCOTT RUNNELS, D.M.D., P.A. RETIREMENT PLAN AND TRUST
|
2010
|
593594939
|
2011-10-10
|
M. SCOTT RUNNELS, D.M.D., P.A.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8502690333
|
| Plan sponsor’s
address |
4399 COMMONS DRIVE EAST, DESTIN, FL, 32541
|
Plan administrator’s name and address
| Administrator’s EIN |
593594939 |
| Plan administrator’s name |
M. SCOTT RUNNELS, D.M.D., P.A. |
| Plan administrator’s
address |
4399 COMMONS DRIVE EAST, DESTIN, FL, 32541 |
| Administrator’s telephone number |
8502690333 |
Signature of
| Role |
Plan administrator |
| Date |
2011-10-10 |
| Name of individual signing |
M. SCOTT RUNNELS, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-10-10 |
| Name of individual signing |
M SCOTT RUNNELS DMD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
M. SCOTT RUNNELS, D.M.D., P.A. RETIREMENT PLAN AND TRUST
|
2009
|
593594939
|
2010-10-14
|
M. SCOTT RUNNELS, D.M.D., P.A.
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8502690333
|
| Plan sponsor’s
address |
4399 COMMONS DRIVE EAST, DESTIN, FL, 32541
|
Plan administrator’s name and address
| Administrator’s EIN |
593594939 |
| Plan administrator’s name |
M. SCOTT RUNNELS, D.M.D., P.A. |
| Plan administrator’s
address |
4399 COMMONS DRIVE EAST, DESTIN, FL, 32541 |
| Administrator’s telephone number |
8502690333 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-13 |
| Name of individual signing |
M. SCOTT RUNNELS, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-10-13 |
| Name of individual signing |
M. SCOTT RUNNELS, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
