STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2023
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112318535
|
2024-09-07
|
STEVEN DIVACK, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2024-09-07 |
Name of individual signing |
STEVEN DIVACK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2022
|
112318535
|
2023-09-16
|
STEVEN DIVACK, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2023-09-16 |
Name of individual signing |
STEVEN DIVACK |
|
|
STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2021
|
112318535
|
2022-09-02
|
STEVEN DIVACK, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2022-09-02 |
Name of individual signing |
STEVEN DIVACK |
|
|
STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2020
|
112318535
|
2021-02-18
|
STEVEN DIVACK, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2021-02-18 |
Name of individual signing |
STEVEN DIVACK |
|
|
STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2019
|
112318535
|
2020-09-08
|
STEVEN DIVACK, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2020-09-08 |
Name of individual signing |
STEVEN DIVACK |
|
|
STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2018
|
112318535
|
2019-10-09
|
STEVEN DIVACK, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2019-10-09 |
Name of individual signing |
STEVEN DIVACK |
|
|
STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2017
|
112318535
|
2018-10-03
|
STEVEN DIVACK, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2018-10-03 |
Name of individual signing |
STEVEN DIVACK |
|
|
STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2016
|
112318535
|
2017-10-12
|
STEVEN DIVACK, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2017-10-12 |
Name of individual signing |
STEVEN DIVACK |
|
|
STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2015
|
112318535
|
2016-09-09
|
STEVEN DIVACK, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2016-09-09 |
Name of individual signing |
STEVEN DIVACK |
|
|
STEVEN DIVACK, M.D., P.C. PENSION TRUST
|
2014
|
112318535
|
2015-10-14
|
STEVEN DIVACK, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7186388484
|
Plan sponsor’s
address |
115 EASTERN PARKWAY, BROOKLYN, NY, 11238
|
Signature of
Role |
Plan administrator |
Date |
2015-10-14 |
Name of individual signing |
STEVEN DIVACK |
|
|