DERMATOLOGY IN HAMDEN, LLC 401(K) PROFIT SHARING PLAN
|
2019
|
061468032
|
2020-06-05
|
DERMATOLOGY IN HAMDEN, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
495 DEERCLIFF RD, AVON, CT, 06001
|
Signature of
Role |
Plan administrator |
Date |
2020-06-05 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERMATOLOGY IN HAMDEN, LLC 401(K)
|
2019
|
061468032
|
2020-11-19
|
DERMATOLOGY IN HAMDEN, LLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
495 DEERCLIFF RD, AVON, CT, 06001
|
Signature of
Role |
Plan administrator |
Date |
2020-11-19 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERMATOLOGY IN HAMDEN, LLC 401(K) PROFIT SHARING PLAN
|
2018
|
061468032
|
2019-05-06
|
DERMATOLOGY IN HAMDEN, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
2880 OLD DIXWELL AVE., HAMDEN, CT, 06518
|
Signature of
Role |
Plan administrator |
Date |
2019-05-06 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERMATOLOGY IN HAMDEN, LLC 401(K) PROFIT SHARING PLAN
|
2017
|
061468032
|
2018-05-31
|
DERMATOLOGY IN HAMDEN, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
2880 OLD DIXWELL AVE., HAMDEN, CT, 06518
|
Signature of
Role |
Plan administrator |
Date |
2018-05-31 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERMATOLOGY IN HAMDEN, LLC 401(K) PROFIT SHARING PLAN
|
2016
|
061468032
|
2017-04-11
|
DERMATOLOGY IN HAMDEN, LLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
2880 OLD DIXWELL AVE., HAMDEN, CT, 06518
|
Signature of
Role |
Plan administrator |
Date |
2017-04-11 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERMATOLOGY IN HAMDEN, LLC 401(K) PROFIT SHARING PLAN
|
2015
|
061468032
|
2016-05-11
|
DERMATOLOGY IN HAMDEN, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
2880 OLD DIXWELL AVE., HAMDEN, CT, 06518
|
Signature of
Role |
Plan administrator |
Date |
2016-05-11 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERMATOLOGY IN HAMDEN, LLC 401(K) PROFIT SHARING PLAN
|
2014
|
061468032
|
2015-06-16
|
DERMATOLOGY IN HAMDEN, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
2880 OLD DIXWELL AVE., HAMDEN, CT, 06518
|
Signature of
Role |
Plan administrator |
Date |
2015-06-16 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERMATOLOGY IN HAMDEN, LLC 401(K) PROFIT SHARING PLAN
|
2013
|
061468032
|
2014-05-23
|
DERMATOLOGY IN HAMDEN, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
2880 OLD DIXWELL AVE., HAMDEN, CT, 06518
|
Signature of
Role |
Plan administrator |
Date |
2014-05-23 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERMATOLOGY IN HAMDEN, LLC 401(K) PROFIT SHARING PLAN
|
2012
|
061468032
|
2013-05-24
|
DERMATOLOGY IN HAMDEN, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
2880 OLD DIXWELL AVE., HAMDEN, CT, 06518
|
Signature of
Role |
Plan administrator |
Date |
2013-05-24 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERMATOLOGY IN HAMDEN, LLC 401(K) PROFIT SHARING PLAN
|
2011
|
061468032
|
2012-09-14
|
DERMATOLOGY IN HAMDEN, LLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032885624
|
Plan sponsor’s
address |
2880 OLD DIXWELL AVE., HAMDEN, CT, 06518
|
Plan administrator’s name and address
Administrator’s EIN |
061468032 |
Plan administrator’s name |
DERMATOLOGY IN HAMDEN, LLC |
Plan administrator’s
address |
2880 OLD DIXWELL AVE., HAMDEN, CT, 06518 |
Administrator’s telephone number |
2032885624 |
Signature of
Role |
Plan administrator |
Date |
2012-09-14 |
Name of individual signing |
PETER SHERLINE, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|