PETER A. SMALL, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2017
|
061575822
|
2018-12-18
|
PETER A. SMALL, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032590538
|
Plan sponsor’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824
|
Signature of
Role |
Plan administrator |
Date |
2018-12-18 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-12-15 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER A. SMALL, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2016
|
061575822
|
2018-06-05
|
PETER A. SMALL, M.D., P.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032590538
|
Plan sponsor’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824
|
Signature of
Role |
Plan administrator |
Date |
2018-06-05 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER A. SMALL, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2015
|
061575822
|
2017-08-09
|
PETER A. SMALL, M.D., P.C.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032597400
|
Plan sponsor’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824
|
Signature of
Role |
Plan administrator |
Date |
2017-08-09 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER A. SMALL, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2014
|
061575822
|
2016-08-03
|
PETER A. SMALL, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032597400
|
Plan sponsor’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824
|
Signature of
Role |
Plan administrator |
Date |
2016-08-03 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER A. SMALL, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2013
|
061575822
|
2015-08-12
|
PETER A. SMALL, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032597400
|
Plan sponsor’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824
|
Signature of
Role |
Plan administrator |
Date |
2015-08-12 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER A. SMALL, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2012
|
061575822
|
2014-08-15
|
PETER A. SMALL, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032597400
|
Plan sponsor’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824
|
Signature of
Role |
Plan administrator |
Date |
2014-08-13 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER A. SMALL, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2011
|
061575822
|
2013-05-09
|
PETER A. SMALL, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032597400
|
Plan sponsor’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824
|
Plan administrator’s name and address
Administrator’s EIN |
061575822 |
Plan administrator’s name |
PETER A. SMALL, M.D., P.C. |
Plan administrator’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824 |
Administrator’s telephone number |
2032597400 |
Signature of
Role |
Plan administrator |
Date |
2013-05-09 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER A. SMALL, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2010
|
061575822
|
2012-04-12
|
PETER A. SMALL, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032597400
|
Plan sponsor’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824
|
Plan administrator’s name and address
Administrator’s EIN |
061575822 |
Plan administrator’s name |
PETER A. SMALL, M.D., P.C. |
Plan administrator’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824 |
Administrator’s telephone number |
2032597400 |
Signature of
Role |
Plan administrator |
Date |
2012-04-12 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PETER A. SMALL, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2009
|
061575822
|
2011-05-05
|
PETER A. SMALL, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
2032597400
|
Plan sponsor’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824
|
Plan administrator’s name and address
Administrator’s EIN |
061575822 |
Plan administrator’s name |
PETER A. SMALL, M.D., P.C. |
Plan administrator’s
address |
2119 POST ROAD, FAIRFIELD, CT, 06824 |
Administrator’s telephone number |
2032597400 |
Signature of
Role |
Plan administrator |
Date |
2011-05-05 |
Name of individual signing |
PETER SMALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|