I S S EMPLOYEE BENEFITS PLAN
|
2020
|
050535944
|
2022-06-17
|
INDEPENDENT SUPPORT SERVICES, INC.
|
440
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2019-11-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
20 CRYSTAL STREET, P.O. BOX 1320, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
20 CRYSTAL STREET, P.O. BOX 1320, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Active participants |
426 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2022-06-17 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
I S S EMPLOYEE BENEFITS PLAN
|
2019
|
050535944
|
2021-05-10
|
INDEPENDENT SUPPORT SERVICES, INC.
|
427
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2019-11-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
P.O. BOX 1320, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-05-10 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-05-10 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
I S S VISION PLAN
|
2018
|
050535944
|
2020-04-27
|
INDEPENDENT SUPPORT SERVICES, INC.
|
322
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2018-11-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
P.O BOX 1320, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-04-27 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
I S S DENTAL PLAN
|
2018
|
050535944
|
2020-04-27
|
INDEPENDENT SUPPORT SERVICES, INC.
|
337
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2018-11-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
P.O. BOX 1320, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-04-27 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
I S S EMPLOYEE BENEFITS PLAN
|
2018
|
050535944
|
2020-04-21
|
INDEPENDENT SUPPORT SERVICES, INC.
|
383
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2018-05-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
P.O. BOX 1320, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-04-20 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
I S S VISION PLAN
|
2017
|
050535944
|
2020-04-22
|
INDEPENDENT SUPPORT SERVICES, INC.
|
231
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2017-11-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
P.O BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
P.O. BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-04-22 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
I S S DENTAL PLAN
|
2017
|
050535944
|
2020-04-22
|
INDEPENDENT SUPPORT SERVICES, INC.
|
256
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-11-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
P.O. BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
P.O. BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-04-22 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
I S S DENTAL PLAN
|
2017
|
050535944
|
2019-08-28
|
INDEPENDENT SUPPORT SERVICES, INC.
|
256
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-11-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
P.O. BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
P.O. BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-08-28 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
I S S EMPLOYEE BENEFITS PLAN
|
2017
|
050535944
|
2019-08-28
|
INDEPENDENT SUPPORT SERVICES, INC.
|
298
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2017-11-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
P.O. BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
P.O. BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-08-28 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
I S S VISION PLAN
|
2017
|
050535944
|
2019-08-28
|
INDEPENDENT SUPPORT SERVICES, INC.
|
231
|
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2017-11-01
|
Business code |
624100
|
Sponsor’s telephone number |
8457945218
|
Plan sponsor’s mailing address |
P.O BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Plan sponsor’s
address |
P.O. BOX 1320, 20 CRYSTAL STREET, MONTICELLO, NY, 12701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-08-28 |
Name of individual signing |
ALAN KULCHINSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|