DIANE L. FOUNTAS, M.D. PROFIT SHARING PLAN
|
2015
|
800264317
|
2016-09-21
|
DIANE L. FOUNTAS, M.D. LLC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1995-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037536776
|
Plan sponsor’s
address |
1389 WEST MAIN STREET SUITE 325, WATERBURY, CT, 06708
|
Signature of
Role |
Plan administrator |
Date |
2016-09-21 |
Name of individual signing |
DIANE FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DIANE L. FOUNTAS, M.D. PROFIT SHARING PLAN
|
2015
|
800264317
|
2016-09-21
|
DIANE L. FOUNTAS, M.D. LLC
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1995-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037536776
|
Plan sponsor’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708
|
Signature of
Role |
Plan administrator |
Date |
2016-09-21 |
Name of individual signing |
DIANE FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DIANE L. FOUNTAS, M.D. PROFIT SHARING PLAN
|
2014
|
800264317
|
2015-10-03
|
DIANE L FOUNTAS, M.D. LLC
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1995-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037536776
|
Plan sponsor’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708
|
Signature of
Role |
Plan administrator |
Date |
2015-10-03 |
Name of individual signing |
DIANE FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DIANE L. FOUNTAS, M.D. PROFIT SHARING PLAN
|
2013
|
800264317
|
2014-05-23
|
DIANE L. FOUNTAS, M.D. LLC
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1995-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037536776
|
Plan sponsor’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708
|
Signature of
Role |
Plan administrator |
Date |
2014-05-23 |
Name of individual signing |
DIANE FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DIANE L. FOUNTAS, M.D. PROFIT SHARING PLAN
|
2012
|
800264317
|
2013-07-17
|
DIANE L FOUNTAS, M.D. LLC
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1995-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037536776
|
Plan sponsor’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708
|
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
DIANE FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DIANE L. FOUNTAS, M.D. PROFIT SHARING PLAN
|
2011
|
800264317
|
2012-10-12
|
DIANE L FOUNTAS, M.D. LLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1995-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037536776
|
Plan sponsor’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708
|
Plan administrator’s name and address
Administrator’s EIN |
800264317 |
Plan administrator’s name |
DIANE L FOUNTAS, M.D. LLC |
Plan administrator’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708 |
Administrator’s telephone number |
2037536776 |
Signature of
Role |
Plan administrator |
Date |
2012-10-12 |
Name of individual signing |
DIANE FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DIANE L. FOUNTAS, M.D. PROFIT SHARING PLAN
|
2010
|
800264317
|
2011-07-19
|
DIANE L FOUNTAS, M.D. LLC
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1995-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037536776
|
Plan sponsor’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708
|
Plan administrator’s name and address
Administrator’s EIN |
800264317 |
Plan administrator’s name |
DIANE L FOUNTAS, M.D. LLC |
Plan administrator’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708 |
Administrator’s telephone number |
2037536776 |
Signature of
Role |
Plan administrator |
Date |
2011-07-19 |
Name of individual signing |
DIANE L. FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-19 |
Name of individual signing |
DIANE L. FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DIANE L. FOUNTAS, M.D. PROFIT SHARING PLAN
|
2009
|
800264317
|
2010-07-26
|
DIANE L. FOUNTAS, M.D. LLC
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037536776
|
Plan sponsor’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708
|
Plan administrator’s name and address
Administrator’s EIN |
800264317 |
Plan administrator’s name |
DIANE L. FOUNTAS, M.D. LLC |
Plan administrator’s
address |
1389 W MAIN ST SUITE 325, WATERBURY, CT, 06708 |
Administrator’s telephone number |
2037536776 |
Signature of
Role |
Plan administrator |
Date |
2010-07-26 |
Name of individual signing |
DIANE FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-26 |
Name of individual signing |
DIANE FOUNTAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|