SOUTH BAY MEDICAL CARE, P.C. RETIREMENT PLAN
|
2023
|
113419719
|
2024-09-30
|
SOUTH BAY MEDICAL CARE, P.C.
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5168787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2024-09-30 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-09-30 |
Name of individual signing |
DAVID GOLDMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SOUTH BAY MEDICAL CARE, P.C. RETIREMENT PLAN
|
2022
|
113419719
|
2023-10-09
|
SOUTH BAY MEDICAL CARE, P.C.
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6318787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2023-10-09 |
Name of individual signing |
DAVID GOLDMAN |
|
Role |
Employer/plan sponsor |
Date |
2023-10-09 |
Name of individual signing |
DAVID GOLDMAN |
|
|
SOUTH BAY MEDICAL CARE, P.C. RETIREMENT PLAN
|
2021
|
113419719
|
2022-10-06
|
SOUTH BAY MEDICAL CARE, P.C.
|
28
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6318787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2022-10-06 |
Name of individual signing |
DAVID GOLDMAN |
|
Role |
Employer/plan sponsor |
Date |
2022-10-06 |
Name of individual signing |
DAVID GOLDMAN |
|
|
SOUTH BAY MEDICAL CARE, P.C. RETIREMENT PLAN
|
2020
|
113419719
|
2021-06-15
|
SOUTH BAY MEDICAL CARE, P.C.
|
29
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6318787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2021-06-15 |
Name of individual signing |
DAVID GOLDMAN |
|
Role |
Employer/plan sponsor |
Date |
2021-06-15 |
Name of individual signing |
DAVID GOLDMAN |
|
|
SOUTH BAY MEDICAL CARE, P.C. RETIREMENT PLAN
|
2019
|
113419719
|
2020-08-07
|
SOUTH BAY MEDICAL CARE, P.C.
|
29
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6318787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2020-08-07 |
Name of individual signing |
DAVID GOLDMAN |
|
Role |
Employer/plan sponsor |
Date |
2020-08-07 |
Name of individual signing |
DAVID GOLDMAN |
|
|
SOUTH BAY MEDICAL CARE, P.C. RETIREMENT PLAN
|
2018
|
113419719
|
2019-07-12
|
SOUTH BAY MEDICAL CARE, P.C.
|
29
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6318787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2019-07-12 |
Name of individual signing |
DAVID T. GOLDMAN, MD |
|
Role |
Employer/plan sponsor |
Date |
2019-07-12 |
Name of individual signing |
DAVID T. GOLDMAN, MD |
|
|
SOUTH BAY MEDICAL CARE, P.C. RETIREMENT PLAN
|
2017
|
113419719
|
2018-09-20
|
SOUTH BAY MEDICAL CARE, P.C.
|
27
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5168787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2018-09-20 |
Name of individual signing |
DAVID GOLDMAN |
|
Role |
Employer/plan sponsor |
Date |
2018-09-20 |
Name of individual signing |
DAVID GOLDMAN |
|
|
SOUTH BAY MEDICAL CARE, P.C. RETIREMENT PLAN
|
2016
|
113419719
|
2017-10-06
|
SOUTH BAY MEDICAL CARE, P.C.
|
31
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6318787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2017-10-06 |
Name of individual signing |
DAVID GOLDMAN |
|
Role |
Employer/plan sponsor |
Date |
2017-10-06 |
Name of individual signing |
DAVID GOLDMAN |
|
|
SOUTH BAY MEDICAL CARE, P.C. DEFINED BENEFIT PENSION PLAN
|
2015
|
113419719
|
2017-03-15
|
SOUTH BAY MEDICAL CARE, P.C.
|
31
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2004-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5168787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2017-03-15 |
Name of individual signing |
DAVID GOLDMAN |
|
Role |
Employer/plan sponsor |
Date |
2017-03-15 |
Name of individual signing |
DAVID GOLDMAN |
|
|
SOUTH BAY MEDICAL CARE, P.C. RETIREMENT PLAN
|
2015
|
113419719
|
2016-07-29
|
SOUTH BAY MEDICAL CARE, P.C.
|
29
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6318787134
|
Plan sponsor’s
address |
625 MONTAUK HIGHWAY, CENTER MORICHES, NY, 119342200
|
Signature of
Role |
Plan administrator |
Date |
2016-07-28 |
Name of individual signing |
DAVID GOLDMAN |
|
Role |
Employer/plan sponsor |
Date |
2016-07-28 |
Name of individual signing |
DAVID GOLDMAN |
|
|