|
JON M. ERICKSON, M.D., P.C. SAFE HARBOR 401K PLAN
|
2011
|
841277012
|
2012-07-16
|
JON M. ERICKSON, M.D., P.C.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3039268734
|
| Plan sponsor’s
address |
500 DISCOVERY PARKWAY, SUITE 125, SUPERIOR, CO, 80027
|
Plan administrator’s name and address
| Administrator’s EIN |
841277012 |
| Plan administrator’s name |
JON M. ERICKSON, M.D., P.C. |
| Plan administrator’s
address |
500 DISCOVERY PARKWAY, SUITE 125, SUPERIOR, CO, 80027 |
| Administrator’s telephone number |
3039268734 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-16 |
| Name of individual signing |
JON M. ERICKSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-07-16 |
| Name of individual signing |
JON M. ERICKSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JON M. ERICKSON, M.D., P.C. SAFE HARBOR 401K PLAN
|
2010
|
841277012
|
2011-05-19
|
JON M. ERICKSON, M.D., P.C.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3039268734
|
| Plan sponsor’s
address |
500 DISCOVERY PARKWAY, SUITE 125, SUPERIOR, CO, 80027
|
Plan administrator’s name and address
| Administrator’s EIN |
841277012 |
| Plan administrator’s name |
JON M. ERICKSON, M.D., P.C. |
| Plan administrator’s
address |
500 DISCOVERY PARKWAY, SUITE 125, SUPERIOR, CO, 80027 |
| Administrator’s telephone number |
3039268734 |
Signature of
| Role |
Plan administrator |
| Date |
2011-05-19 |
| Name of individual signing |
JON M. ERICKSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-05-19 |
| Name of individual signing |
JON M. ERICKSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JON M. ERICKSON, M.D., P.C. SAFE HARBOR 401K PLAN
|
2009
|
841277012
|
2010-07-06
|
JON M. ERICKSON, M.D., P.C.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3039268734
|
| Plan sponsor’s
address |
500 DISCOVERY PARKWAY, SUITE 125, SUPERIOR, CO, 80027
|
Plan administrator’s name and address
| Administrator’s EIN |
841277012 |
| Plan administrator’s name |
JON M. ERICKSON, M.D., P.C. |
| Plan administrator’s
address |
500 DISCOVERY PARKWAY, SUITE 125, SUPERIOR, CO, 80027 |
| Administrator’s telephone number |
3039268734 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-06 |
| Name of individual signing |
JON M. ERICKSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-07-06 |
| Name of individual signing |
JON M. ERICKSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
