POLICH TALLIX INC. 401(K) PROFIT SHARING PLAN AND TRUST
|
2015
|
454085367
|
2016-08-04
|
POLICH TALLIX INC.
|
50
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8455679464
|
Plan sponsor’s
address |
453 STATE ROUTE 17K, ROCK TAVERN, NY, 125755011
|
Signature of
Role |
Plan administrator |
Date |
2016-08-04 |
Name of individual signing |
MICHAEL GROSSMAN |
|
|
POLICH TALLIX INC. 401(K) PROFIT SHARING PLAN AND TRUST
|
2014
|
454085367
|
2015-10-08
|
POLICH TALLIX INC.
|
87
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8455679464
|
Plan sponsor’s
address |
453 ROUTE 17K, ROCK TAVERN, NY, 12575
|
Signature of
Role |
Plan administrator |
Date |
2015-10-08 |
Name of individual signing |
MICHAEL GROSSMAN |
|
|
POLICH TALLIX INC. 401(K) PROFIT SHARING PLAN & TRUST
|
2013
|
454085367
|
2015-07-31
|
POLICH TALLIX INC
|
99
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Plan sponsor’s
address |
453 ROUTE 17K, ROCK TAVERN, NY, 12575
|
Signature of
Role |
Plan administrator |
Date |
2015-07-31 |
Name of individual signing |
RICHARD POLICH |
|
Role |
Employer/plan sponsor |
Date |
2015-07-31 |
Name of individual signing |
RICHARD POLICH |
|
|
POLICH TALLIX INC 401(K) PROFIT SHARING PLAN & TRUST
|
2012
|
454085367
|
2015-07-31
|
POLICH TALLIX INC
|
97
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8455679464
|
Plan sponsor’s
address |
453 ROUTE 17K, ROCK TAVERN, NY, 12575
|
Signature of
Role |
Plan administrator |
Date |
2015-07-31 |
Name of individual signing |
RICHARD POLICH |
|
Role |
Employer/plan sponsor |
Date |
2015-07-31 |
Name of individual signing |
RICHARD POLICH |
|
|
POLICH TALLIX INC 401(K) PROFIT SHARING PLAN AND TRUST
|
2011
|
454085367
|
2015-07-31
|
POLICH TALLIX INC
|
93
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8455679464
|
Plan sponsor’s
address |
453 ROUTE 17K, ROCK TAVERN, NY, 12575
|
Plan administrator’s name and address
Administrator’s EIN |
454085367 |
Plan administrator’s name |
POLICH TALLIX INC |
Plan administrator’s
address |
453 ROUTE 17K, ROCK TAVERN, NY, 12575 |
Administrator’s telephone number |
8455679464 |
Signature of
Role |
Plan administrator |
Date |
2015-07-31 |
Name of individual signing |
RICHARD POLICH |
|
Role |
Employer/plan sponsor |
Date |
2015-07-31 |
Name of individual signing |
RICHARD POLICH |
|
|