|
25/34 PLASTIC SURGERY ASSOCIATES, PC RETIREMENT PLAN
|
2010
|
260724842
|
2011-08-02
|
25/34 PLASTIC SURGERY ASSOCIATES, PC
|
8
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9706247979
|
| Plan sponsor’s
address |
4450 UNION STREET, SUITE 100, JOHNSTOWN, CO, 80534
|
Plan administrator’s name and address
| Administrator’s EIN |
260724842 |
| Plan administrator’s name |
25/34 PLASTIC SURGERY ASSOCIATES, PC |
| Plan administrator’s
address |
4450 UNION STREET, SUITE 100, JOHNSTOWN, CO, 80534 |
| Administrator’s telephone number |
9706247979 |
Signature of
| Role |
Plan administrator |
| Date |
2011-08-02 |
| Name of individual signing |
DENIS GONYON, JR. |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
|
25/34 PLASTIC SURGERY ASSOCIATES, PC RETIREMENT PLAN
|
2010
|
260724842
|
2011-08-02
|
25/34 PLASTIC SURGERY ASSOCIATES, PC
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9706247979
|
| Plan sponsor’s
address |
4450 UNION STREET, SUITE 100, JOHNSTOWN, CO, 80534
|
Plan administrator’s name and address
| Administrator’s EIN |
260724842 |
| Plan administrator’s name |
25/34 PLASTIC SURGERY ASSOCIATES, PC |
| Plan administrator’s
address |
4450 UNION STREET, SUITE 100, JOHNSTOWN, CO, 80534 |
| Administrator’s telephone number |
9706247979 |
Signature of
| Role |
Plan administrator |
| Date |
2011-08-02 |
| Name of individual signing |
DENIS GONYON, JR. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
25/34 PLASTIC SURGERY ASSOCIATES, PC RETIREMENT PLAN
|
2010
|
260724842
|
2011-04-28
|
25/34 PLASTIC SURGERY ASSOCIATES PC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9706247979
|
| Plan sponsor’s
address |
4450 UNION STREET, STE 100, JOHNSTOWN, CO, 80534
|
Plan administrator’s name and address
| Administrator’s EIN |
260724842 |
| Plan administrator’s name |
25/34 PLASTIC SURGERY ASSOCIATES PC |
| Plan administrator’s
address |
4450 UNION STREET, STE 100, JOHNSTOWN, CO, 80534 |
| Administrator’s telephone number |
9706247979 |
Signature of
| Role |
Plan administrator |
| Date |
2011-04-28 |
| Name of individual signing |
JOHN R. ROBERSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-04-28 |
| Name of individual signing |
DENIS GONYON, JR. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
25/34 PLASTIC SURGERY ASSOCIATES, PC RETIREMENT TRUST
|
2009
|
260724842
|
2010-10-08
|
25/34 PLASTIC SURGERY ASSOCIATES PC
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9706247979
|
| Plan sponsor’s
address |
4450 UNION STREET, JOHNSTOWN, CO, 80534
|
Plan administrator’s name and address
| Administrator’s EIN |
260724842 |
| Plan administrator’s name |
25/34 PLASTIC SURGERY ASSOCIATES PC |
| Plan administrator’s
address |
4450 UNION STREET, JOHNSTOWN, CO, 80534 |
| Administrator’s telephone number |
9706247979 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-08 |
| Name of individual signing |
JOHN R. ROBERSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-10-08 |
| Name of individual signing |
DENIS GONYON, JR. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
