|
SYOSSET INTERNAL MEDICINE, P.C. RETIREMENT TRUST
|
2012
|
113018928
|
2013-09-12
|
SYOSSET INTERNAL MEDICINE, P.C.
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1997-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5168275757
|
| Plan sponsor’s
address |
1097 OLD COUNTRY ROAD, STE 201, PLAINVIEW, NY, 11803
|
Signature of
| Role |
Plan administrator |
| Date |
2013-09-12 |
| Name of individual signing |
EDWARD GOYDAS |
|
|
|
SYOSSET INTERNAL MEDICINE, P.C. RETIREMENT TRUST
|
2011
|
113018928
|
2012-07-17
|
SYOSSET INTERNAL MEDICINE, P.C.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1997-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5168275757
|
| Plan sponsor’s mailing address |
1097 OLD COUNTRY RD, STE 201, PLAINVIEW, NY, 11803
|
| Plan sponsor’s
address |
1097 OLD COUNTRY RD, STE 201, PLAINVIEW, NY, 11803
|
Plan administrator’s name and address
| Administrator’s EIN |
113018928 |
| Plan administrator’s name |
SYOSSET INTERNAL MEDICINE, P.C. |
| Plan administrator’s
address |
1097 OLD COUNTRY RD, STE 201, PLAINVIEW, NY, 11803 |
| Administrator’s telephone number |
5168275757 |
Number of participants as of the end of the plan year
| Active participants |
5 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
5 |
| 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 |
2012-07-17 |
| Name of individual signing |
FRANK AMICO |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SYOSSET INTERNAL MEDICINE, P.C. RETIREMENT TRUST
|
2010
|
113018928
|
2011-04-29
|
SYOSSET INTERNAL MEDICINE, P.C.
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1997-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5168275757
|
| Plan sponsor’s
address |
1097 OLD COUNTRY ROAD, PLAINVIEW, NY, 11803
|
Plan administrator’s name and address
| Administrator’s EIN |
113018928 |
| Plan administrator’s name |
SYOSSET INTERNAL MEDICINE, P.C. |
| Plan administrator’s
address |
1097 OLD COUNTRY ROAD, PLAINVIEW, NY, 11803 |
| Administrator’s telephone number |
5168275757 |
Signature of
| Role |
Plan administrator |
| Date |
2011-04-29 |
| Name of individual signing |
FRANK AMICO |
|
|
|
SYOSSET INTERNAL MEDICINE, P.C. RETIREMENT TRUST
|
2009
|
113018928
|
2010-07-01
|
SYOSSET INTERNAL MEDICINE, P.C.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1997-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5168275757
|
| Plan sponsor’s
address |
1097 OLD COUNTRY ROAD, PLAINVIEW, NY, 11803
|
Plan administrator’s name and address
| Administrator’s EIN |
113018928 |
| Plan administrator’s name |
SYOSSET INTERNAL MEDICINE, P.C. |
| Plan administrator’s
address |
1097 OLD COUNTRY ROAD, PLAINVIEW, NY, 11803 |
| Administrator’s telephone number |
5168275757 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-01 |
| Name of individual signing |
FRANK AMICO |
|
|
