UNITED SERVICE SOURCE, INC. PREMIUM ONLY PLAN
|
2014
|
593063999
|
2015-10-21
|
NATIONAL SERVICE SOURCE, INC.
|
112
|
|
File |
View Page
|
Three-digit plan number (PN) |
550
|
Effective date of plan |
1999-07-23
|
Business code |
541519
|
Sponsor’s telephone number |
3217235395
|
Plan
sponsor’s DBA name |
UNITED SERVICE SOURCE, INC.
|
Plan sponsor’s mailing address |
9145 ELLIS ROAD, MELBOURNE, FL, 32904
|
Plan sponsor’s
address |
9145 ELLIS ROAD, MELBOURNE, FL, 32904
|
Number of participants as of the end of the plan year
Active participants |
103 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-10-21 |
Name of individual signing |
ANN CONN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNITED SERVICE SOURCE, INC. PREMIUM ONLY PLAN
|
2013
|
593063999
|
2015-06-18
|
NATIONAL SERVICE SOURCE, INC.
|
139
|
|
File |
View Page
|
Three-digit plan number (PN) |
550
|
Effective date of plan |
1999-07-23
|
Business code |
541519
|
Sponsor’s telephone number |
3217235395
|
Plan
sponsor’s DBA name |
UNITED SERVICE SOURCE, INC.
|
Plan sponsor’s mailing address |
9145 ELLIS ROAD, MELBOURNE, FL, 32904
|
Plan sponsor’s
address |
9145 ELLIS ROAD, MELBOURNE, FL, 32904
|
Number of participants as of the end of the plan year
Active participants |
112 |
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 |
Signature of
Role |
Plan administrator |
Date |
2015-06-18 |
Name of individual signing |
ANN CONN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-06-18 |
Name of individual signing |
ANN CONN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNTIED SERVICE SOURCE, INC. PREMIUM ONLY PLAN
|
2012
|
593063999
|
2015-04-13
|
NATIONAL SERVICE SOURCE, INC.
|
149
|
|
File |
View Page
|
Three-digit plan number (PN) |
550
|
Effective date of plan |
1999-07-23
|
Business code |
541519
|
Sponsor’s telephone number |
3217235395
|
Plan
sponsor’s DBA name |
UNITED SERVICE SOURCE, INC.
|
Plan sponsor’s mailing address |
9145 ELLIS ROAD, MELBOURNE, FL, 32904
|
Plan sponsor’s
address |
9145 ELLIS ROAD, MELBOURNE, FL, 32904
|
Number of participants as of the end of the plan year
Active participants |
139 |
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 |
Signature of
Role |
Plan administrator |
Date |
2015-04-13 |
Name of individual signing |
ANN CONN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-04-13 |
Name of individual signing |
ANN CONN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNITED SERVICE SOURCE, INC. PREMIUM ONLY PLAN
|
2011
|
593063999
|
2012-09-27
|
NATIONAL SERVICE SOURCE, INC.
|
141
|
|
File |
View Page
|
Three-digit plan number (PN) |
550
|
Effective date of plan |
1999-07-23
|
Business code |
541519
|
Sponsor’s telephone number |
3217235395
|
Plan
sponsor’s DBA name |
UNITED SERVICE SOURCE, INC.
|
Plan sponsor’s mailing address |
9145 ELLIS ROAD, MELBOURNE, FL, 32904
|
Plan sponsor’s
address |
9145 ELLIS ROAD, MELBOURNE, FL, 32904
|
Plan administrator’s name and address
Administrator’s EIN |
593063999 |
Plan administrator’s name |
NATIONAL SERVICE SOURCE, INC. |
Plan administrator’s
address |
9145 ELLIS ROAD, MELBOURNE, FL, 32904 |
Administrator’s telephone number |
3217235395 |
Number of participants as of the end of the plan year
Active participants |
149 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-09-27 |
Name of individual signing |
ANN CONN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|