FUCCILLO AUTOMOTIVE GROUP, INC. GROUP HEALTH PLAN
|
2022
|
161533157
|
2024-06-14
|
FUCCILLO AUTOMOTIVE GROUP,INC
|
103
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3155753529
|
Plan sponsor’s mailing address |
10524 U.S. ROUTE 11, ADAMS, NY, 136050069
|
Plan sponsor’s
address |
10524 U.S. ROUTE 11, ADAMS, NY, 136050069
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FUCCILLO AUTOMOTIVE GROUP, INC. GROUP HEALTH PLAN
|
2021
|
161533157
|
2023-06-13
|
FUCCILLO AUTOMOTIVE GROUP, INC.
|
287
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3155753529
|
Plan
sponsor’s DBA name |
FUCCILLO NISSAN OF CLEARWATER
|
Plan sponsor’s mailing address |
10524 U.S. ROUTE 11, PO BOX 69, ADAMS, NY, 136050069
|
Plan sponsor’s
address |
10524 U.S. ROUTE 11, PO BOX 69, ADAMS, NY, 136050069
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-06-13 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-06-13 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FUCCILLO AUTOMOTIVE GROUP, INC. GROUP HEALTH PLAN
|
2020
|
161533157
|
2022-06-14
|
FUCCILLO AUTOMOTIVE GROUP, INC.
|
543
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3155753529
|
Plan sponsor’s mailing address |
10524 U.S. ROUTE 11, PO BOX 69, ADAMS, NY, 136050069
|
Plan sponsor’s
address |
10524 U.S. ROUTE 11, PO BOX 69, ADAMS, NY, 136050069
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FUCCILLO AUTOMOTIVE GROUP, INC. GROUP HEALTH PLAN
|
2019
|
161533157
|
2021-05-12
|
FUCCILLO AUTOMOTIVE GROUP, INC.
|
689
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3152323222
|
Plan
sponsor’s DBA name |
FUCCILLO NISSAN OF CLEARWATER
|
Plan sponsor’s mailing address |
10524 U.S. ROUTE 11, PO BOX 69, ADAMS, NY, 136050069
|
Plan sponsor’s
address |
10524 U.S. ROUTE 11, PO BOX 69, ADAMS, NY, 136050069
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-05-12 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-05-12 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FUCCILLO AUTOMOTIVE GROUP, INC. GROUP HEALTH PLAN
|
2018
|
161533157
|
2020-07-15
|
FUCCILLO AUTOMOTIVE GROUP, INC.
|
716
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3152323222
|
Plan sponsor’s mailing address |
10524 U.S. ROUTE 11, P.O. BOX 69, ADAMS, NY, 136050069
|
Plan sponsor’s
address |
10524 U.S. ROUTE 11, P.O. BOX 69, ADAMS, NY, 136050069
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-07-15 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-07-15 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FUCCILLO AUTOMOTIVE GROOUP, INC, GROUP HEALTH PLAN
|
2017
|
161533157
|
2019-06-14
|
FUCCILLO AUTOMOTIVE GROUP, INC.
|
721
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3152323222
|
Plan sponsor’s mailing address |
10524 U.S. ROUTE 11, P.O. BOX 69, ADAMS, NY, 136050069
|
Plan sponsor’s
address |
10524 U.S. ROUTE 11, P.O. BOX 69, ADAMS, NY, 136050069
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FUCCILLO AUTOMOTIVE GROUP, INC. GROUP HEALTH PLAN
|
2016
|
161533157
|
2018-06-14
|
FUCCILLO AUTOMOTIVE GROUP, INC.
|
703
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3152323222
|
Plan sponsor’s mailing address |
10524 U.S. ROUTE 11, PO BOX 69, ADAMS, NY, 136050069
|
Plan sponsor’s
address |
10524 U.S. ROUTE 11, PO BOX 69, ADAMS, NY, 136050069
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FUCCILLO AUTOMOTIVE GROUP, INC. GROUP HEALTH PLAN
|
2015
|
161533157
|
2017-06-15
|
FUCCILLO AUTOMOTIVE GROUP, INC.
|
655
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3152323222
|
Plan sponsor’s mailing address |
10524 U.S. ROUTE 11, P.O. BOX 69, ADAMS, NY, 136090069
|
Plan sponsor’s
address |
10524 U.S. ROUTE 11, P.O. BOX 69, ADAMS, NY, 136090069
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-06-15 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-15 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FUCCILLO AUTOMOTIVE GROUP, INC. GROUP HEALTH PLAN
|
2014
|
161533157
|
2016-06-14
|
FUCCILLO AUTOMOTIVE GROUP, INC.
|
603
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3152323222
|
Plan sponsor’s mailing address |
10524 U.S. ROUTE 11, P.O. BOX 69, ADAMS, NY, 136050069
|
Plan sponsor’s
address |
10524 U.S. ROUTE 11, P.O. BOX 69, ADAMS, NY, 136050069
|
Number of participants as of the end of the plan year
Active participants |
651 |
Retired or separated participants receiving
benefits |
4 |
Signature of
Role |
Plan administrator |
Date |
2016-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-06-14 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FUCCILLO AUTOMOTIVE GROUP, INC. GROUP HEALTH PLAN
|
2013
|
161533157
|
2015-06-11
|
FUCCILLO AUTOMOTIVE GROUP, INC.
|
590
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-09-01
|
Business code |
441110
|
Sponsor’s telephone number |
3152323222
|
Plan sponsor’s mailing address |
10524 U.S.ROUTE 11, P.O. BOX 69, ADAMS, NY, 136050069
|
Plan sponsor’s
address |
10524 U.S.ROUTE 11, P.O. BOX 69, ADAMS, NY, 136050069
|
Number of participants as of the end of the plan year
Active participants |
600 |
Retired or separated participants receiving
benefits |
3 |
Signature of
Role |
Plan administrator |
Date |
2015-06-11 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-06-11 |
Name of individual signing |
BRUCE LEWIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|