BROADWAY VIDEO INC LONG-TERM DISABILTY PLAN
|
2018
|
522282474
|
2019-07-26
|
BROADWAY VIDEO INC
|
114
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Sponsor’s telephone number |
2122657600
|
Plan sponsor’s mailing address |
1619 BROADWAY, NEW YORK, NY, 100197412
|
Plan sponsor’s
address |
1619 BROADWAY, NEW YORK, NY, 100197412
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-26 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-07-26 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROADWAY VIDEO INC GROUP INSURANCE PLAN
|
2017
|
522282474
|
2018-07-20
|
BROADWAY VIDEO INC
|
130
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Sponsor’s telephone number |
2126030633
|
Plan sponsor’s mailing address |
1619 BROADWAY, NEW YORK, NY, 10019
|
Plan sponsor’s
address |
1619 BROADWAY, NEW YORK, NY, 10019
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-07-20 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-07-20 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROADWAY VIDEO INC. LONG-TERM DISABILITY PLAN
|
2017
|
522282474
|
2018-07-26
|
BROADWAY VIDEO, INC.
|
139
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Sponsor’s telephone number |
2122657600
|
Plan sponsor’s mailing address |
1619 BROADWAY, NEW YORK, NY, 10019
|
Plan sponsor’s
address |
1619 BROADWAY, NEW YORK, NY, 10019
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-07-26 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-07-26 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROADWAY VIDEO INC GROUP INSURANCE PLAN
|
2016
|
522282474
|
2017-07-27
|
BROADWAY VIDEO INC
|
109
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Sponsor’s telephone number |
2122657600
|
Plan
sponsor’s DBA name |
BROADWAY VIDEO INC
|
Plan sponsor’s mailing address |
1619 BROADWAY, NEW YORK, NY, 100197412
|
Plan sponsor’s
address |
1619 BROADWAY, NEW YORK, NY, 100197412
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-27 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-27 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROADWAY VIDEO INC LONG-TERM DISABILITY PLAN
|
2016
|
522282474
|
2017-07-21
|
BROADWAY VIDEO INC
|
117
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Sponsor’s telephone number |
2122657600
|
Plan sponsor’s mailing address |
1619 BROADWAY FL 4, NEW YORK, NY, 100197740
|
Plan sponsor’s
address |
1619 BROADWAY FL 4, NEW YORK, NY, 100197740
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-21 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-21 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROADWAY VIDEO INC. LONG-TERM DISABILITY PLAN
|
2015
|
522282474
|
2016-07-27
|
BROADWAY VIDEO INC
|
95
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Sponsor’s telephone number |
2122657600
|
Plan
sponsor’s DBA name |
BROADWAY VIDEO ENTERTAINMENT INC
|
Plan sponsor’s mailing address |
1619 BROADWAY 4TH FL, NEW YORK, NY, 100197412
|
Plan sponsor’s
address |
1619 BROADWAY 4TH FL, NEW YORK, NY, 100197412
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-27 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-27 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROADWAY VIDEO INC. GROUP INSURANCE PLAN
|
2015
|
522282474
|
2016-07-14
|
BROADWAY VIDEO INC
|
95
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Sponsor’s telephone number |
2122657600
|
Plan sponsor’s mailing address |
1619 BROADWAY 4TH FL, NEW YORK, NY, 100197412
|
Plan sponsor’s
address |
1619 BROADWAY 4TH FL, NEW YORK, NY, 100197412
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-14 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-14 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROADWAY VIDEO INC GROUP INSURANCE PLAN
|
2013
|
522282474
|
2014-08-11
|
BROADWAY VIDEO INC.
|
156
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Sponsor’s telephone number |
2126030686
|
Plan sponsor’s mailing address |
1619 BROADWAY, NEW YORK, NY, 10019
|
Plan sponsor’s
address |
1619 BROADWAY, NEW YORK, NY, 10019
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-08-11 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-08-11 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROADWAY VIDEO INC. GROUP INSURANCE PLAN
|
2012
|
522282474
|
2013-10-04
|
BROADWAY VIDEO INC.
|
145
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Sponsor’s telephone number |
2126030686
|
Plan sponsor’s mailing address |
1619BROADWAY, NEW YORK, NY, 10019
|
Plan sponsor’s
address |
1619BROADWAY, NEW YORK, NY, 10019
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-04 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-04 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROADWAY VIDEO INC. GROUP INSURANCE PLAN
|
2011
|
522282474
|
2012-10-08
|
BROADWAY VIDEO INC
|
154
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1992-01-01
|
Business code |
512100
|
Plan sponsor’s mailing address |
1619 BROADWAY, NEW YORK, NY, 10019
|
Plan sponsor’s
address |
1619 BROADWAY, NEW YORK, NY, 10019
|
Plan administrator’s name and address
Administrator’s EIN |
522282474 |
Plan administrator’s name |
BROADWAY VIDEO INC |
Plan administrator’s
address |
1619 BROADWAY, NEW YORK, NY, 10019 |
Administrator’s telephone number |
2126030686 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-08 |
Name of individual signing |
HOWARD GROUDAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|