|
GOLD STAR PEDIATRICS, LLC 401(K) PROFIT SHARING PLAN
|
2012
|
263918079
|
2013-03-04
|
GOLD STAR PEDIATRICS, LLC
|
13
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
1986-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8604498882
|
| Plan sponsor’s
address |
495 ROUTE 184, GROTON, CT, 063406228
|
Signature of
| Role |
Plan administrator |
| Date |
2013-02-08 |
| Name of individual signing |
MICHAEL BLEFELD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-02-08 |
| Name of individual signing |
MICHAEL BLEFELD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GOLD STAR PEDIATRICS, LLC 401(K) PROFIT SHARING PLAN
|
2011
|
263918079
|
2012-04-18
|
GOLD STAR PEDIATRICS, LLC
|
13
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
1986-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8604498882
|
| Plan sponsor’s
address |
495 ROUTE 184, GROTON, CT, 063406228
|
Plan administrator’s name and address
| Administrator’s EIN |
263918079 |
| Plan administrator’s name |
GOLD STAR PEDIATRICS, LLC |
| Plan administrator’s
address |
495 ROUTE 184, GROTON, CT, 063406228 |
| Administrator’s telephone number |
8604498882 |
Signature of
| Role |
Plan administrator |
| Date |
2012-04-17 |
| Name of individual signing |
MICHAEL E. BLEFELD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-04-17 |
| Name of individual signing |
MICHAEL E. BLEFELD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GOLD STAR PEDIATRICS, LLC 401(K) PROFIT SHARING PLAN
|
2010
|
263918079
|
2011-09-26
|
GOLD STAR PEDIATRICS, LLC
|
12
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
1986-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8604498882
|
| Plan sponsor’s
address |
495 ROUTE 184, GROTON, CT, 063406228
|
Plan administrator’s name and address
| Administrator’s EIN |
263918079 |
| Plan administrator’s name |
GOLD STAR PEDIATRICS, LLC |
| Plan administrator’s
address |
495 ROUTE 184, GROTON, CT, 063406228 |
| Administrator’s telephone number |
8604498882 |
Signature of
| Role |
Plan administrator |
| Date |
2011-09-25 |
| Name of individual signing |
MICHAEL BLEFELD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-09-25 |
| Name of individual signing |
MICHAEL BLEFELD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GOLD STAR PEDIATRICS, LLC 401(K) PROFIT SHARING PLAN
|
2009
|
263918079
|
2010-07-17
|
GOLD STAR PEDIATRICS, LLC
|
12
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
003
|
| Effective date of plan |
1986-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8604498882
|
| Plan sponsor’s
address |
495 ROUTE 184, GROTON, CT, 063406228
|
Plan administrator’s name and address
| Administrator’s EIN |
263918079 |
| Plan administrator’s name |
GOLD STAR PEDIATRICS, LLC |
| Plan administrator’s
address |
495 ROUTE 184, GROTON, CT, 063406228 |
| Administrator’s telephone number |
8604498882 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-17 |
| Name of individual signing |
MICHAEL BLEFELD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-07-17 |
| Name of individual signing |
MICHAEL BLEFELD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
