|
HERITAGE VILLAGE PHARMACY INC 401(K) PROFIT SHARING PLAN & TRUST
|
2020
|
901003975
|
2021-04-13
|
HERITAGE VILLAGE PHARMACY INC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
812990
|
| Sponsor’s telephone number |
2012708013
|
| Plan sponsor’s
address |
6 THATCHER TER, FARMINGTON, CT, 060321566
|
Signature of
| Role |
Plan administrator |
| Date |
2021-04-13 |
| Name of individual signing |
RAJENDRA APPLALANENI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
HERITAGE VILLAGE PHARMACY INC 401(K) PROFIT SHARING PLAN & TRUST
|
2019
|
901003975
|
2020-07-09
|
HERITAGE VILLAGE PHARMACY INC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
812990
|
| Sponsor’s telephone number |
2012708013
|
| Plan sponsor’s
address |
6 THATCHER TER, FARMINGTON, CT, 060321566
|
Signature of
| Role |
Plan administrator |
| Date |
2020-07-09 |
| Name of individual signing |
RAJENDRA APPALANENI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
HERITAGE VILLAGE PHARMACY INC 401 K PROFIT SHARING PLAN TRUST
|
2018
|
901003975
|
2019-03-20
|
HERITAGE VILLAGE PHARMACY INC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
812990
|
| Sponsor’s telephone number |
2012708013
|
| Plan sponsor’s
address |
493 HERITAGE RD, SOUTHBURY, CT, 06488
|
Signature of
| Role |
Plan administrator |
| Date |
2019-03-20 |
| Name of individual signing |
RAJENDRA APPALANENI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
HERITAGE VILLAGE PHARMACY INC 401 K PROFIT SHARING PLAN TRUST
|
2017
|
901003975
|
2018-03-16
|
HERITAGE VILLAGE PHARMACY INC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
812990
|
| Sponsor’s telephone number |
2012708013
|
| Plan sponsor’s
address |
493 HERITAGE RD, SOUTHBURY, CT, 06488
|
Signature of
| Role |
Plan administrator |
| Date |
2018-03-16 |
| Name of individual signing |
RAJENDRA APPALANENI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
HERITAGE VILLAGE PHARMACY INC 401 K PROFIT SHARING PLAN TRUST
|
2016
|
901003975
|
2017-05-19
|
HERITAGE VILLAGE PHARMACY INC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2016-01-01
|
| Business code |
812990
|
| Sponsor’s telephone number |
2012708013
|
| Plan sponsor’s
address |
493 HERITAGE RD, SOUTHBURY, CT, 06488
|
Signature of
| Role |
Plan administrator |
| Date |
2017-05-19 |
| Name of individual signing |
RAJENDRA APPALANENI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
HERITAGE HOME CARE INC PROFIT SHARING PLAN
|
2009
|
061202112
|
2010-09-09
|
HERITAGE VILLAGE PHARMACY INC
|
3
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-01-01
|
| Business code |
446110
|
| Sponsor’s telephone number |
2037922798
|
| Plan sponsor’s mailing address |
72 CANTERBURY LANE, RIDGEFIELD, CT, 06877
|
| Plan sponsor’s
address |
72 CANTERBURY LANE, RIDGEFIELD, CT, 06877
|
Plan administrator’s name and address
| Administrator’s EIN |
061202112 |
| Plan administrator’s name |
HERITAGE VILLAGE PHARMACY INC |
| Plan administrator’s
address |
72 CANTERBURY LANE, RIDGEFIELD, CT, 06877 |
| Administrator’s telephone number |
2037922798 |
Number of participants as of the end of the plan year
| Active participants |
0 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
0 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Employer/plan sponsor |
| Date |
2010-09-09 |
| Name of individual signing |
JAROSLAW PALYLYK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
HERITAGE HOME CARE INC PROFIT SHARING PLAN
|
2009
|
061202112
|
2010-09-09
|
HERITAGE VILLAGE PHARMACY INC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-01-01
|
| Business code |
446110
|
| Sponsor’s telephone number |
2037922798
|
| Plan sponsor’s mailing address |
72 CANTERBURY LANE, RIDGEFIELD, CT, 06877
|
| Plan sponsor’s
address |
72 CANTERBURY LANE, RIDGEFIELD, CT, 06877
|
Plan administrator’s name and address
| Administrator’s EIN |
061202112 |
| Plan administrator’s name |
HERITAGE VILLAGE PHARMACY INC |
| Plan administrator’s
address |
72 CANTERBURY LANE, RIDGEFIELD, CT, 06877 |
| Administrator’s telephone number |
2037922798 |
Number of participants as of the end of the plan year
| Active participants |
0 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
0 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-09-09 |
| Name of individual signing |
JAROSLAW PALYLYK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
