MONTROSE SURGICAL ASSOCIATES, P.C. PENSION PLAN
|
2019
|
841443156
|
2021-02-03
|
K. MICHAEL JAY, M.D., P.C.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2014-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s
address |
611 E STAR COURT, SUITE A, MONTROSE, CO, 81401
|
Signature of
Role |
Plan administrator |
Date |
2021-02-03 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MONTROSE SURGICAL ASSOCIATES, P.C. PENSION PLAN
|
2018
|
841443156
|
2020-08-12
|
K. MICHAEL JAY, M.D., P.C.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2014-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s
address |
611 E STAR COURT, SUITE A, MONTROSE, CO, 81401
|
Signature of
Role |
Plan administrator |
Date |
2020-08-12 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MONTROSE SURGICAL ASSOCIATES, P.C. PENSION PLAN
|
2017
|
841443156
|
2019-06-07
|
K. MICHAEL JAY, M.D., P.C.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s
address |
611 E STAR COURT, SUITE A, MONTROSE, CO, 81401
|
Signature of
Role |
Plan administrator |
Date |
2019-06-07 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MONTROSE SURGICAL ASSOCIATES, P.C. PENSION PLAN
|
2016
|
841443156
|
2018-08-16
|
K. MICHAEL JAY, M.D., P.C.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2014-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s
address |
611 E STAR COURT, SUITE A, MONTROSE, CO, 81401
|
Signature of
Role |
Plan administrator |
Date |
2018-08-16 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MONTROSE SURGICAL ASSOCIATES, P.C. PENSION PLAN
|
2015
|
841443156
|
2017-07-27
|
K MICHAEL JAY, M.D., P.C.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s
address |
611 E STAR CT STE A, MONTROSE, CO, 814016704
|
Signature of
Role |
Plan administrator |
Date |
2017-07-27 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MONTROSE SURGICAL ASSOCIATES, PC DEFINED BENEFIT PENSION PLAN
|
2015
|
841443156
|
2017-02-20
|
K. MICHAEL JAY, M.D., P.C.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s
address |
611 E STAR CT STE A, MONTROSE, CO, 814016704
|
Signature of
Role |
Plan administrator |
Date |
2017-02-19 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MONTROSE SURGICAL ASSOCIATES, PC DEFINED BENEFIT PENSION PLAN
|
2014
|
841443156
|
2016-02-23
|
K. MICHAEL JAY, M.D., P.C.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1981-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s
address |
611 E STAR COURT, SUITE A, MONTROSE, CO, 81401
|
Signature of
Role |
Plan administrator |
Date |
2016-02-23 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MONTROSE SURGICAL ASSOCIATES, P.C. PENSION PLAN
|
2014
|
841443156
|
2016-08-15
|
K MICHAEL JAY, M.D., P.C.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s
address |
611 E START COURT, SUITE A, MONTROSE, CO, 81401
|
Signature of
Role |
Plan administrator |
Date |
2016-08-12 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MONTROSE SURGICAL ASSOCIATES PC PENSION PLAN
|
2013
|
841443156
|
2014-04-22
|
K. MICHAEL JAY, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s mailing address |
611 E. STAR COURT, SUITE A, MONTROSE, CO, 81401
|
Plan sponsor’s
address |
611 E. STAR COURT, SUITE A, MONTROSE, CO, 81401
|
Number of participants as of the end of the plan year
Active participants |
3 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
4 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
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 |
2014-02-20 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MONTROSE SURGICAL ASSOCIATES, P.C. PENSION PLAN
|
2013
|
841443156
|
2015-07-23
|
K MICHAEL JAY, M.D., P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
9702494321
|
Plan sponsor’s
address |
611 E START COURT, SUITE A, MONTROSE, CO, 81401
|
Signature of
Role |
Plan administrator |
Date |
2015-07-19 |
Name of individual signing |
KIERAN JAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|