|
MODERN ERA PEDIATRIC PRACTICE 401 K PROFIT SHARING PLAN TRUST
|
2016
|
651219184
|
2017-07-25
|
MODERN ERA PEDIATRICS LLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621510
|
| Sponsor’s telephone number |
2033714800
|
| Plan sponsor’s
address |
3715 MAIN STREET, SUITE 403, BRIDGEPORT, CT, 06606
|
Signature of
| Role |
Plan administrator |
| Date |
2017-07-25 |
| Name of individual signing |
ANSELM ANYOHA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN ERA PEDIATRIC PRACTICE 401 K PROFIT SHARING PLAN TRUST
|
2015
|
651219184
|
2016-08-31
|
MODERN ERA PEDIATRICS LLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621510
|
| Sponsor’s telephone number |
2033714800
|
| Plan sponsor’s
address |
3715 MAIN STREET, SUITE 403, BRIDGEPORT, CT, 06606
|
Signature of
| Role |
Plan administrator |
| Date |
2016-08-31 |
| Name of individual signing |
ANSELM ANYOHA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN ERA PEDIATRIC PRACTICE 401 K PROFIT SHARING PLAN TRUST
|
2014
|
651219184
|
2016-08-31
|
MODERN ERA PEDIATRICS LLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621510
|
| Sponsor’s telephone number |
2033714800
|
| Plan sponsor’s
address |
3715 MAIN STREET, SUITE 403, BRIDGEPORT, CT, 06606
|
Signature of
| Role |
Plan administrator |
| Date |
2016-08-31 |
| Name of individual signing |
ANSELM ANYOHA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN ERA PEDIATRIC PRACTICE 401 K PROFIT SHARING PLAN TRUST
|
2013
|
651219184
|
2014-07-17
|
MODERN ERA PEDIATRICS LLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621510
|
| Sponsor’s telephone number |
2033714800
|
| Plan sponsor’s
address |
3715 MAIN STREET, SUITE 403, BRIDGEPORT, CT, 06606
|
Signature of
| Role |
Plan administrator |
| Date |
2014-07-17 |
| Name of individual signing |
ANSELMANYOHA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN ERA PEDIATRIC PRACTICE 401 K PROFIT SHARING PLAN TRUST
|
2012
|
651219184
|
2014-07-17
|
MODERN ERA PEDIATRICS LLC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621510
|
| Sponsor’s telephone number |
2033714800
|
| Plan sponsor’s
address |
3715 MAIN STREET, SUITE 403, BRIDGEPORT, CT, 06606
|
Signature of
| Role |
Plan administrator |
| Date |
2014-07-17 |
| Name of individual signing |
MODERN ERA PEDIATRICS LLC |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MODERN ERA PEDIATRICS LLC 401 K PROFIT SHARING PLAN TRUST
|
2011
|
651219184
|
2014-07-17
|
MODERN ERA PEDIATRICS LLC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621510
|
| Sponsor’s telephone number |
2033714800
|
| Plan sponsor’s
address |
3715 MAIN STREET SUITE 403, BRIDGEPORT, CT, 06606
|
Plan administrator’s name and address
| Administrator’s EIN |
651219184 |
| Plan administrator’s name |
MODERN ERA PEDIATRICS LLC |
| Plan administrator’s
address |
3715 MAIN STREET SUITE 403, BRIDGEPORT, CT, 06606 |
| Administrator’s telephone number |
2033714800 |
Signature of
| Role |
Plan administrator |
| Date |
2014-07-17 |
| Name of individual signing |
MODERN ERA PEDIATRICS LLC |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
