|
ITHACA DERMATOLOGY, PLLC 401(K) PROFIT SHARING PLAN & TRUST
|
2014
|
260726161
|
2016-06-24
|
ITHACA DERMATOLOGY, PLLC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621399
|
| Sponsor’s telephone number |
6078731832
|
| Plan sponsor’s
address |
C/O AMS DERMATOLOGY, 2977 WESTINGHOUSE ROAD, HORSEHEADS, NY, 14845
|
Signature of
| Role |
Plan administrator |
| Date |
2016-06-24 |
| Name of individual signing |
KIMBERLY SILVERS |
|
|
|
ITHACA DERMATOLOGY PLLC 401 K PROFIT SHARING PLAN TRUST
|
2013
|
260726161
|
2014-07-08
|
ITHACA DERMATOLOGY PLLC
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621399
|
| Sponsor’s telephone number |
6072567546
|
| Plan sponsor’s
address |
821 CLIFF ST, ITHACA, NY, 148502097
|
Signature of
| Role |
Plan administrator |
| Date |
2014-07-08 |
| Name of individual signing |
KIMBERLY SILVERS |
|
|
|
ITHACA DERMATOLOGY PLLC 401 K PROFIT SHARING PLAN TRUST
|
2012
|
260726161
|
2013-07-19
|
ITHACA DERMATOLOGY PLLC
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621399
|
| Sponsor’s telephone number |
6072567546
|
| Plan sponsor’s
address |
821 CLIFF ST, ITHACA, NY, 148502097
|
Signature of
| Role |
Plan administrator |
| Date |
2013-07-19 |
| Name of individual signing |
ITHACA DERMATOLOGY PLLC |
|
|
|
ITHACA DERMATOLOGY PLLC 401 K PROFIT SHARING PLAN TRUST
|
2011
|
260726161
|
2012-07-24
|
ITHACA DERMATOLOGY PLLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6072567546
|
| Plan sponsor’s
address |
821 CLIFF ST, ITHACA, NY, 148502097
|
Plan administrator’s name and address
| Administrator’s EIN |
260726161 |
| Plan administrator’s name |
ITHACA DERMATOLOGY PLLC |
| Plan administrator’s
address |
821 CLIFF ST, ITHACA, NY, 148502097 |
| Administrator’s telephone number |
6072567546 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-24 |
| Name of individual signing |
ITHACA DERMATOLOGY PLLC |
|
|
|
ITHACA DERMATOLOGY PLLC 401 K PROFIT SHARING PLAN TRUST
|
2010
|
260726161
|
2011-08-03
|
ITHACA DERMATOLOGY PLLC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6072567546
|
| Plan sponsor’s
address |
821 CLIFF ST, ITHACA, NY, 14850
|
Plan administrator’s name and address
| Administrator’s EIN |
260726161 |
| Plan administrator’s name |
ITHACA DERMATOLOGY PLLC |
| Plan administrator’s
address |
821 CLIFF ST, ITHACA, NY, 14850 |
| Administrator’s telephone number |
6072567546 |
Signature of
| Role |
Plan administrator |
| Date |
2011-08-03 |
| Name of individual signing |
ITHACA DERMATOLOGY PLLC |
|
|
