ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2023
|
593601636
|
2024-05-02
|
ALEXANDRA KOSTICK, M.D., P.A.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
|
ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2022
|
593601636
|
2023-10-02
|
ALEXANDRA KOSTICK, M.D., P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
Plan administrator’s name and address
Administrator’s EIN |
593601636 |
Plan administrator’s name |
ALEXANDRA KOSTICK, M.D., P.A. |
Plan administrator’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137 |
Administrator’s telephone number |
3864469590 |
|
ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2021
|
593601636
|
2022-02-25
|
ALEXANDRA KOSTICK, M.D., P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
Plan administrator’s name and address
Administrator’s EIN |
593601636 |
Plan administrator’s name |
ALEXANDRA KOSTICK, M.D., P.A. |
Plan administrator’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137 |
Administrator’s telephone number |
3864469590 |
|
ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2020
|
593601636
|
2021-03-03
|
ALEXANDRA KOSTICK, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
Plan administrator’s name and address
Administrator’s EIN |
593601636 |
Plan administrator’s name |
ALEXANDRA KOSTICK, M.D., P.A. |
Plan administrator’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137 |
Administrator’s telephone number |
3864469590 |
Signature of
Role |
Plan administrator |
Date |
2021-03-03 |
Name of individual signing |
ALEXANDRA KOSTICK, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2019
|
593601636
|
2020-05-11
|
ALEXANDRA KOSTICK, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
Plan administrator’s name and address
Administrator’s EIN |
593601636 |
Plan administrator’s name |
ALEXANDRA KOSTICK, M.D., P.A. |
Plan administrator’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137 |
Administrator’s telephone number |
3864469590 |
|
ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2018
|
593601636
|
2019-06-25
|
ALEXANDRA KOSTICK, M.D., P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
Plan administrator’s name and address
Administrator’s EIN |
593601636 |
Plan administrator’s name |
ALEXANDRA KOSTICK, M.D., P.A. |
Plan administrator’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137 |
Administrator’s telephone number |
3864469590 |
Signature of
Role |
Plan administrator |
Date |
2019-06-25 |
Name of individual signing |
ALEXANDRA KOSTICK, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2017
|
593601636
|
2018-06-24
|
ALEXANDRA KOSTICK, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
Plan administrator’s name and address
Administrator’s EIN |
593601636 |
Plan administrator’s name |
ALEXANDRA KOSTICK, M.D., P.A. |
Plan administrator’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137 |
Administrator’s telephone number |
3864469590 |
Signature of
Role |
Plan administrator |
Date |
2018-06-24 |
Name of individual signing |
ALEXANDRA KOSTICK, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2016
|
593601636
|
2017-07-31
|
ALEXANDRA KOSTICK, M.D., P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
Plan administrator’s name and address
Administrator’s EIN |
593601636 |
Plan administrator’s name |
ALEXANDRA KOSTICK, M.D., P.A. |
Plan administrator’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137 |
Administrator’s telephone number |
3864469590 |
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
ALEXANDRA KOSTICK, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2015
|
593601636
|
2016-10-04
|
ALEXANDRA KOSTICK, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
Plan administrator’s name and address
Administrator’s EIN |
593601636 |
Plan administrator’s name |
ALEXANDRA KOSTICK, M.D., P.A. |
Plan administrator’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137 |
Administrator’s telephone number |
3864469590 |
Signature of
Role |
Plan administrator |
Date |
2016-10-04 |
Name of individual signing |
ALEXANDRA KOSTICK, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALEXANDRA KOSTICK, M.D. 401(K) PROFIT SHARING PLAN AND TRUST
|
2014
|
593601636
|
2015-07-27
|
ALEXANDRA KOSTICK, M.D., P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3864469590
|
Plan sponsor’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137
|
Plan administrator’s name and address
Administrator’s EIN |
593601636 |
Plan administrator’s name |
ALEXANDRA KOSTICK, M.D., P.A. |
Plan administrator’s
address |
3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32137 |
Administrator’s telephone number |
3864469590 |
Signature of
Role |
Plan administrator |
Date |
2015-07-27 |
Name of individual signing |
ALEXANDRA KOSTICK, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|