POMFRET SCHOOL HEALTH AND WELFARE PLAN
|
2017
|
060646784
|
2019-01-31
|
POMFRET SCHOOL
|
134
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636140
|
Plan sponsor’s mailing address |
398 POMFRET STREET, PO BOX 128, POMFRET, CT, 062580128
|
Plan sponsor’s
address |
398 POMFRET STEET, POMFRET, CT, 06258
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-01-31 |
Name of individual signing |
EDWARD GRIFFIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
POMFRET SCHOOL INCORPORATED WELFARE WRAP BENEFITS PLAN
|
2016
|
060646784
|
2017-11-29
|
POMFRET SCHOOL
|
136
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636140
|
Plan sponsor’s mailing address |
398 POMFRET STREET, P.O. BOX 128, POMFRET, CT, 06258
|
Plan sponsor’s
address |
398 POMFRET STREET, POMFRET, CT, 06258
|
Plan administrator’s name and address
Administrator’s EIN |
060646784 |
Plan administrator’s name |
POMFRET SCHOOL INCORPORATED |
Plan administrator’s
address |
P.O. BOX 128, POMFRET, CT, 06258 |
Administrator’s telephone number |
8609636100 |
Number of participants as of the end of the plan year
Active participants |
134 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
|
POMFRET SCHOOL INCORPORATED WELFARE WRAP BENEFITS PLAN
|
2015
|
060646784
|
2016-09-30
|
POMFRET SCHOOL
|
136
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636140
|
Plan sponsor’s mailing address |
398 POMFRET STREET, P.O. BOX 128, POMFRET, CT, 06258
|
Plan sponsor’s
address |
398 POMFRET STREET, POMFRET, CT, 06258
|
Plan administrator’s name and address
Administrator’s EIN |
060646784 |
Plan administrator’s name |
POMFRET SCHOOL INCORPORATED |
Plan administrator’s
address |
P.O. BOX 128, POMFRET, CT, 06258 |
Administrator’s telephone number |
8609636100 |
Number of participants as of the end of the plan year
Active participants |
136 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
|
POMFRET SCHOOL INCORPORATED WELFARE WRAP BENEFITS PLAN
|
2014
|
060646784
|
2015-10-20
|
POMFRET SCHOOL
|
138
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636140
|
Plan sponsor’s mailing address |
398 POMFRET STREET, P.O. BOX 128, POMFRET, CT, 06258
|
Plan sponsor’s
address |
398 POMFRET STREET, POMFRET, CT, 06258
|
Plan administrator’s name and address
Administrator’s EIN |
060646784 |
Plan administrator’s name |
POMFRET SCHOOL INCORPORATED |
Plan administrator’s
address |
P.O. BOX 128, POMFRET, CT, 06258 |
Administrator’s telephone number |
8609636100 |
Number of participants as of the end of the plan year
Active participants |
136 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-10-20 |
Name of individual signing |
EDWARD GRIFFIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
POMFRET SCHOOL INCORPORATED WELFARE WRAP BENEFITS PLAN
|
2013
|
060646784
|
2014-09-30
|
POMFRET SCHOOL INCORPORATED
|
137
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636100
|
Plan sponsor’s mailing address |
P.O. BOX 128, POMFRET, CT, 06258
|
Plan sponsor’s
address |
398 POMFRET STREET, POMFRET, CT, 06258
|
Plan administrator’s name and address
Administrator’s EIN |
060646784 |
Plan administrator’s name |
POMFRET SCHOOL INCORPORATED |
Plan administrator’s
address |
P.O. BOX 128, POMFRET, CT, 06258 |
Administrator’s telephone number |
8609636100 |
Number of participants as of the end of the plan year
Active participants |
138 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-09-30 |
Name of individual signing |
ARTHUR C. DIAZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
POMFRET SCHOOL INCORPORATED WELFARE BENEFITS PLAN
|
2012
|
060646784
|
2013-12-04
|
POMFRET SCHOOL INCORPORATED
|
135
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636100
|
Plan sponsor’s mailing address |
P.O. BOX 128, POMFRET, CT, 06258
|
Plan sponsor’s
address |
398 POMFRET STREET, POMFRET, CT, 06258
|
Plan administrator’s name and address
Administrator’s EIN |
060646784 |
Plan administrator’s name |
POMFRET SCHOOL INCORPORATED |
Plan administrator’s
address |
P.O. BOX 128, POMFRET, CT, 06258 |
Administrator’s telephone number |
8609636100 |
Number of participants as of the end of the plan year
Active participants |
137 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-12-04 |
Name of individual signing |
ARTHUR C. DIAZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
POMFRET SCHOOL INCORPORATED WELFARE BENEFITS PLAN
|
2011
|
060646784
|
2012-12-13
|
POMFRET SCHOOL INCORPORATED
|
132
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636100
|
Plan sponsor’s mailing address |
P.O. BOX 128, POMFRET, CT, 06258
|
Plan sponsor’s
address |
398 POMFRET STREET, POMFRET, CT, 06258
|
Plan administrator’s name and address
Administrator’s EIN |
060646784 |
Plan administrator’s name |
POMFRET SCHOOL INCORPORATED |
Plan administrator’s
address |
P.O. BOX 128, POMFRET, CT, 06258 |
Administrator’s telephone number |
8609636100 |
Number of participants as of the end of the plan year
Active participants |
135 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-12-13 |
Name of individual signing |
ARTHUR C. DIAZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
POMFRET SCHOOL INCORPORATED WELFARE BENEFITS PLAN
|
2010
|
060646784
|
2011-12-02
|
POMFRET SCHOOL INCORPORATED
|
131
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636100
|
Plan sponsor’s mailing address |
P.O. BOX 128, POMFRET, CT, 06258
|
Plan sponsor’s
address |
398 POMFRET STREET, POMFRET, CT, 06258
|
Plan administrator’s name and address
Administrator’s EIN |
060646784 |
Plan administrator’s name |
POMFRET SCHOOL INCORPORATED |
Plan administrator’s
address |
P.O. BOX 128, POMFRET, CT, 06258 |
Administrator’s telephone number |
8609636100 |
Number of participants as of the end of the plan year
Active participants |
132 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-12-02 |
Name of individual signing |
ARTHUR C. DIAZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
POMFRET SCHOOL INCORPORATED WELFARE BENEFITS PLAN
|
2010
|
060646784
|
2011-10-31
|
POMFRET SCHOOL INCORPORATED
|
131
|
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636100
|
Plan sponsor’s mailing address |
P.O. BOX 128, POMFRET, CT, 06258
|
Plan sponsor’s
address |
398 POMFRET STREET, POMFRET, CT, 06258
|
Plan administrator’s name and address
Administrator’s EIN |
060646784 |
Plan administrator’s name |
POMFRET SCHOOL INCORPORATED |
Plan administrator’s
address |
P.O. BOX 128, POMFRET, CT, 06258 |
Administrator’s telephone number |
8609636100 |
Number of participants as of the end of the plan year
Active participants |
132 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-10-31 |
Name of individual signing |
ARTHUR C. DIAZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
POMFRET SCHOOL INCORPORATED WELFARE BENEFITS PLAN
|
2010
|
060646784
|
2011-10-30
|
POMFRET SCHOOL INCORPORATED
|
131
|
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2000-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8609636100
|
Plan sponsor’s mailing address |
P.O. BOX 128, POMFRET, CT, 06258
|
Plan sponsor’s
address |
398 POMFRET STREET, POMFRET, CT, 06258
|
Plan administrator’s name and address
Administrator’s EIN |
060646784 |
Plan administrator’s name |
POMFRET SCHOOL INCORPORATED |
Plan administrator’s
address |
P.O. BOX 128, POMFRET, CT, 06258 |
Administrator’s telephone number |
8609636100 |
Number of participants as of the end of the plan year
Active participants |
132 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-10-30 |
Name of individual signing |
ARTHUR C. DIAZ |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|