|
PROFIT SHARING PLAN OF WILLIAM A. ROBERTS MD PC MARILYN DOUGHERTY MD PC
|
2010
|
840832638
|
2011-09-28
|
WILLIAM A. ROBERTS M.D., P.C.
|
17
|
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1987-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3034493770
|
| Plan sponsor’s
address |
385 BROADWAY, BOULDER, CO, 80305
|
Plan administrator’s name and address
| Administrator’s EIN |
840832638 |
| Plan administrator’s name |
WILLIAM A. ROBERTS M.D., P.C. |
| Plan administrator’s
address |
385 BROADWAY, BOULDER, CO, 80305 |
| Administrator’s telephone number |
3034493770 |
Signature of
| Role |
Plan administrator |
| Date |
2011-09-28 |
| Name of individual signing |
WILLIAM A. ROBERTS |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-09-28 |
| Name of individual signing |
WILLIAM A. ROBERTS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PROFIT SHARING PLAN OF WILLIAM A. ROBERTS MD PC MARILYN DOUGHERTY MD PC
|
2010
|
840832638
|
2011-09-28
|
WILLIAM A. ROBERTS M.D., P.C.
|
17
|
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1987-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3034493770
|
| Plan sponsor’s
address |
385 BROADWAY, BOULDER, CO, 80305
|
Plan administrator’s name and address
| Administrator’s EIN |
840832638 |
| Plan administrator’s name |
WILLIAM A. ROBERTS M.D., P.C. |
| Plan administrator’s
address |
385 BROADWAY, BOULDER, CO, 80305 |
| Administrator’s telephone number |
3034493770 |
Signature of
| Role |
Plan administrator |
| Date |
2011-09-28 |
| Name of individual signing |
WILLIAM A. ROBERTS |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
|
PROFIT SHARING PLAN OF WILLIAM A. ROBERTS MD PC MARILYN DOUGHERTY MD PC
|
2010
|
840832638
|
2011-09-28
|
WILLIAM A. ROBERTS M.D., P.C.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1987-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3034493770
|
| Plan sponsor’s
address |
385 BROADWAY, BOULDER, CO, 80305
|
Plan administrator’s name and address
| Administrator’s EIN |
840832638 |
| Plan administrator’s name |
WILLIAM A. ROBERTS M.D., P.C. |
| Plan administrator’s
address |
385 BROADWAY, BOULDER, CO, 80305 |
| Administrator’s telephone number |
3034493770 |
Signature of
| Role |
Plan administrator |
| Date |
2011-09-28 |
| Name of individual signing |
WILLIAM A. ROBERTS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PROFIT SHARING PLAN OF WILLIAM A. ROBERTS MD PC MARILYN DOUGHERTY MD PC
|
2009
|
840832638
|
2010-10-01
|
WILLIAM A. ROBERTS M.D., P.C.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1987-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3034493770
|
| Plan sponsor’s
address |
385 BROADWAY, BOULDER, CO, 80305
|
Plan administrator’s name and address
| Administrator’s EIN |
840832638 |
| Plan administrator’s name |
WILLIAM A. ROBERTS M.D., P.C. |
| Plan administrator’s
address |
385 BROADWAY, BOULDER, CO, 80305 |
| Administrator’s telephone number |
3034493770 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-01 |
| Name of individual signing |
WILLIAM A. ROBERTS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
