A.G. KALAFATIC MD, PLLC RETIREMENT PLAN AND TRUST
|
2012
|
113493940
|
2013-10-10
|
A.G. KALAFATIC MD, PLLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5166051975
|
Plan sponsor’s
address |
4295 HEMPSTEAD TURNPIKE, BETHPAGE, NY, 11714
|
Signature of
Role |
Plan administrator |
Date |
2013-10-10 |
Name of individual signing |
ALFREDO KALAFATIC |
|
Role |
Employer/plan sponsor |
Date |
2013-10-10 |
Name of individual signing |
ALFREDO KALAFATIC |
|
|
A.G. KALAFATIC MD, PLLC RETIREMENT PLAN AND TRUST
|
2011
|
113493940
|
2012-10-13
|
A.G. KALAFATIC MD, PLLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5166051975
|
Plan sponsor’s
address |
4295 HEMPSTEAD TURNPIKE, BETHPAGE, NY, 11714
|
Plan administrator’s name and address
Administrator’s EIN |
113493940 |
Plan administrator’s name |
A.G. KALAFATIC MD, PLLC |
Plan administrator’s
address |
4295 HEMPSTEAD TURNPIKE, BETHPAGE, NY, 11714 |
Administrator’s telephone number |
5166051975 |
Signature of
Role |
Plan administrator |
Date |
2012-10-13 |
Name of individual signing |
ALFREDO KALAFATIC |
|
Role |
Employer/plan sponsor |
Date |
2012-10-13 |
Name of individual signing |
ALFREDO KALAFATIC |
|
|
A.G. KALAFATIC MD, PLLC RETIREMENT PLAN AND TRUST
|
2010
|
113493940
|
2011-10-14
|
A.G. KALAFATIC MD, PLLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5166051975
|
Plan sponsor’s
address |
4295 HEMPSTEAD TURNPIKE, BETHPAGE, NY, 11714
|
Plan administrator’s name and address
Administrator’s EIN |
113493940 |
Plan administrator’s name |
A.G. KALAFATIC MD, PLLC |
Plan administrator’s
address |
4295 HEMPSTEAD TURNPIKE, BETHPAGE, NY, 11714 |
Administrator’s telephone number |
5166051975 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
ALFREDO KALAFATIC |
|
Role |
Employer/plan sponsor |
Date |
2011-10-14 |
Name of individual signing |
ALFREDO KALAFATIC |
|
|
A.G. KALAFATIC MD, PLLC RETIREMENT PLAN AND TRUST
|
2010
|
113493940
|
2011-10-13
|
A.G. KALAFATIC MD, PLLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5167353001
|
Plan sponsor’s
address |
4295 HEMPSTEAD TURNPIKE, BETHPAGE, NY, 11714
|
Plan administrator’s name and address
Administrator’s EIN |
113493940 |
Plan administrator’s name |
A.G. KALAFATIC MD, PLLC |
Plan administrator’s
address |
4295 HEMPSTEAD TURNPIKE, BETHPAGE, NY, 11714 |
Administrator’s telephone number |
5167353001 |
Signature of
Role |
Plan administrator |
Date |
2011-10-13 |
Name of individual signing |
ALFREDO KALAFATIC |
|
Role |
Employer/plan sponsor |
Date |
2011-10-13 |
Name of individual signing |
ALFREDO KALAFATIC |
|
|