IMG LLC 401(K) PLAN
|
2019
|
061620616
|
2020-10-15
|
INTERNAL MEDICINE GROUP, LLC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Signature of
Role |
Plan administrator |
Date |
2020-10-15 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMG LLC 401(K) PLAN
|
2018
|
061620616
|
2019-10-04
|
INTERNAL MEDICINE GROUP, LLC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Signature of
Role |
Plan administrator |
Date |
2019-10-04 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMG LLC 401(K) PLAN
|
2017
|
061620616
|
2018-10-15
|
INTERNAL MEDICINE GROUP, LLC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Signature of
Role |
Plan administrator |
Date |
2018-10-15 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMG LLC 401(K) PLAN
|
2016
|
061620616
|
2017-10-16
|
INTERNAL MEDICINE GROUP, LLC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Signature of
Role |
Plan administrator |
Date |
2017-10-16 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMG LLC 401(K) PLAN
|
2015
|
061620616
|
2016-10-17
|
INTERNAL MEDICINE GROUP, LLC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Signature of
Role |
Plan administrator |
Date |
2016-10-17 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMG LLC 401(K) PLAN
|
2014
|
061620616
|
2015-10-12
|
INTERNAL MEDICINE GROUP, LLC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Signature of
Role |
Plan administrator |
Date |
2015-10-12 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMG LLC 401(K) PLAN
|
2013
|
061620616
|
2014-10-15
|
INTERNAL MEDICINE GROUP, LLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMG LLC 401(K) PLAN
|
2012
|
061620616
|
2015-10-12
|
INTERNAL MEDICINE GROUP, LLC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Signature of
Role |
Plan administrator |
Date |
2015-10-12 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMG LLC 401(K) PLAN
|
2011
|
061620616
|
2012-09-06
|
INTERNAL MEDICINE GROUP, LLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Plan administrator’s name and address
Administrator’s EIN |
061620616 |
Plan administrator’s name |
INTERNAL MEDICINE GROUP, LLC |
Plan administrator’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360 |
Administrator’s telephone number |
8608870010 |
Signature of
Role |
Plan administrator |
Date |
2012-09-06 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-09-06 |
Name of individual signing |
HANNA KACKIELO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMG LLC 401(K) PLAN
|
2010
|
061620616
|
2011-10-19
|
INTERNAL MEDICINE GROUP, LLC
|
6
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
325410
|
Sponsor’s telephone number |
8608870010
|
Plan sponsor’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360
|
Plan administrator’s name and address
Administrator’s EIN |
061620616 |
Plan administrator’s name |
INTERNAL MEDICINE GROUP, LLC |
Plan administrator’s
address |
1 TOWNE PARK PLAZA, NORWICH, CT, 06360 |
Administrator’s telephone number |
8608870010 |
Signature of
Role |
Plan administrator |
Date |
2011-10-19 |
Name of individual signing |
DARIUSZ PIETRUCZUK |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|