AMBI MEDICAL ASSOCIATES, P.C. RETIREMENT TRUST
|
2014
|
112949980
|
2015-06-16
|
AMBI MEDICAL ASSOCIATES, P.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5162940030
|
Plan sponsor’s
address |
110 WILLIS AVENUE, MINEOLA, NY, 11501
|
Signature of
Role |
Plan administrator |
Date |
2015-06-16 |
Name of individual signing |
ANTHONY PETRINI |
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AMBI MEDICAL ASSOCIATES, P.C. RETIREMENT TRUST
|
2013
|
112949980
|
2014-07-09
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AMBI MEDICAL ASSOCIATES, P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5162940030
|
Plan sponsor’s
address |
110 WILLIS AVENUE, MINEOLA, NY, 11501
|
Signature of
Role |
Plan administrator |
Date |
2014-07-09 |
Name of individual signing |
JONATHAN SCHURE |
|
|
AMBI MEDICAL ASSOCIATES P.C. RETIREMENT PLAN
|
2012
|
112949980
|
2013-09-30
|
AMBI MEDICAL ASSOCIATES, P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5162940030
|
Plan sponsor’s
address |
110 WILLIS AVENUE, MINEOLA, NY, 11501
|
Signature of
Role |
Plan administrator |
Date |
2013-09-24 |
Name of individual signing |
JONATHAN SCHURE |
|
|
AMBI MEDICAL ASSOCIATES P.C. RETIREMENT PLAN
|
2011
|
112949980
|
2012-10-05
|
AMBI MEDICAL ASSOCIATES, P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5162940030
|
Plan sponsor’s
address |
110 WILLIS AVENUE, MINEOLA, NY, 11501
|
Plan administrator’s name and address
Administrator’s EIN |
112949980 |
Plan administrator’s name |
AMBI MEDICAL ASSOCIATES, P.C. |
Plan administrator’s
address |
110 WILLIS AVENUE, MINEOLA, NY, 11501 |
Administrator’s telephone number |
5162940030 |
Signature of
Role |
Plan administrator |
Date |
2012-10-02 |
Name of individual signing |
JONATHAN SCHURE |
|
|
AMBI MEDICAL ASSOCIATES P.C. RETIREMENT PLAN
|
2010
|
112949980
|
2011-10-10
|
AMBI MEDICAL ASSOCIATES, P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5162940030
|
Plan sponsor’s
address |
110 WILLIS AVENUE, MINEOLA, NY, 11501
|
Plan administrator’s name and address
Administrator’s EIN |
112949980 |
Plan administrator’s name |
AMBI MEDICAL ASSOCIATES, P.C. |
Plan administrator’s
address |
110 WILLIS AVENUE, MINEOLA, NY, 11501 |
Administrator’s telephone number |
5162940030 |
Signature of
Role |
Plan administrator |
Date |
2011-10-04 |
Name of individual signing |
JONATHAN SCHURE |
|
|
AMBI MEDICAL ASSOCIATES P.C. RETIREMENT PLAN
|
2009
|
112949980
|
2010-10-07
|
AMBI MEDICAL ASSOCIATES, P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5162940030
|
Plan sponsor’s
address |
110 WILLIS AVENUE, MINEOLA, NY, 11501
|
Plan administrator’s name and address
Administrator’s EIN |
112949980 |
Plan administrator’s name |
AMBI MEDICAL ASSOCIATES, P.C. |
Plan administrator’s
address |
110 WILLIS AVENUE, MINEOLA, NY, 11501 |
Administrator’s telephone number |
5162940030 |
Signature of
Role |
Plan administrator |
Date |
2010-09-21 |
Name of individual signing |
DEBORAH C. DILELLO |
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|