SHORELINE INSURANCE AGENCY INC 401(K) PROFIT SHARING PLAN & TRUST
|
2016
|
061299093
|
2017-07-13
|
SIA COMPANY INC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
2032664152
|
Plan
sponsor’s DBA name |
FKA SHORELINE INSURANCE AGENCY INC
|
Plan sponsor’s
address |
37 WEST RD, CLINTON, CT, 064132316
|
Signature of
Role |
Plan administrator |
Date |
2017-07-13 |
Name of individual signing |
JOHN BALDELLI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORELINE INSURANCE AGENCY INC 401 K PROFIT SHARING PLAN TRUST
|
2015
|
061299093
|
2016-07-18
|
SHORELINE INSURANCE AGENCY INC
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
8606697191
|
Plan sponsor’s
address |
239 E MAIN ST, CLINTON, CT, 064132223
|
Signature of
Role |
Plan administrator |
Date |
2016-07-18 |
Name of individual signing |
JOHN BALDELLI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORELINE INSURANCE AGENCY INC 401 K PROFIT SHARING PLAN TRUST
|
2014
|
061299093
|
2015-05-20
|
SHORELINE INSURANCE AGENCY INC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
8606697191
|
Plan sponsor’s
address |
239 E MAIN ST, CLINTON, CT, 064132223
|
Signature of
Role |
Plan administrator |
Date |
2015-05-20 |
Name of individual signing |
DEBRA DROUIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORELINE INSURANCE AGENCY INC 401 K PROFIT SHARING PLAN TRUST
|
2013
|
061299093
|
2014-06-13
|
SHORELINE INSURANCE AGENCY INC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
8606697191
|
Plan sponsor’s
address |
239 E MAIN ST, CLINTON, CT, 064132223
|
Signature of
Role |
Plan administrator |
Date |
2014-06-13 |
Name of individual signing |
DEBRA D DROUIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORELINE INSURANCE AGENCY INC 401 K PROFIT SHARING PLAN TRUST
|
2012
|
061299093
|
2013-07-10
|
SHORELINE INSURANCE AGENCY INC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
8606697191
|
Plan sponsor’s
address |
239 E MAIN ST, CLINTON, CT, 064132223
|
Signature of
Role |
Plan administrator |
Date |
2013-07-10 |
Name of individual signing |
SHORELINE INSURANCE AGENCY INC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORELINE INSURANCE AGENCY INC 401 K PROFIT SHARING PLAN TRUST
|
2011
|
061299093
|
2012-05-16
|
SHORELINE INSURANCE AGENCY INC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
8606697191
|
Plan sponsor’s
address |
239 E MAIN ST, CLINTON, CT, 064132223
|
Plan administrator’s name and address
Administrator’s EIN |
061299093 |
Plan administrator’s name |
SHORELINE INSURANCE AGENCY INC |
Plan administrator’s
address |
239 E MAIN ST, CLINTON, CT, 064132223 |
Administrator’s telephone number |
8606697191 |
Signature of
Role |
Plan administrator |
Date |
2012-05-16 |
Name of individual signing |
SHORELINE INSURANCE AGENCY INC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORELINE INSURANCE AGENCY INC 401 K PROFIT SHARING PLAN TRUST
|
2010
|
061299093
|
2011-07-12
|
SHORELINE INSURANCE AGENCY INC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
8606697191
|
Plan sponsor’s
address |
239 EAST MAIN STREET, CLINTON, CT, 06413
|
Plan administrator’s name and address
Administrator’s EIN |
061299093 |
Plan administrator’s name |
SHORELINE INSURANCE AGENCY INC |
Plan administrator’s
address |
239 EAST MAIN STREET, CLINTON, CT, 06413 |
Administrator’s telephone number |
8606697191 |
Signature of
Role |
Plan administrator |
Date |
2011-07-12 |
Name of individual signing |
SHORELINE INSURANCE AGENCY INC |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-12 |
Name of individual signing |
SHORELINE INSURANCE AGENCY INC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORELINE INSURANCE AGENCY INC
|
2009
|
061299093
|
2010-06-18
|
SHORELINE INSURANCE AGENCY INC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
8606697191
|
Plan sponsor’s
address |
239 EAST MAIN STREET, CLINTON, CT, 06413
|
Plan administrator’s name and address
Administrator’s EIN |
061299093 |
Plan administrator’s name |
SHORELINE INSURANCE AGENCY INC |
Plan administrator’s
address |
239 EAST MAIN STREET, CLINTON, CT, 06413 |
Administrator’s telephone number |
8606697191 |
Signature of
Role |
Plan administrator |
Date |
2010-06-18 |
Name of individual signing |
SHORELINE INSURANCE AGENCY INC |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-06-18 |
Name of individual signing |
SHORELINE INSURANCE AGENCY INC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|