| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2014-01-29
|
| Business code |
621610
|
| Sponsor’s telephone number |
8456103432
|
| Plan
sponsor’s DBA name |
GRISWOLD HOME CARE
|
| Plan sponsor’s mailing address |
15 COLEMAN DR, CAMPBELL HALL, NY, 109162642
|
| Plan sponsor’s
address |
15 RAILROAD AVE, CHESTER, NY, 10918
|
Number of participants as of the end of the plan year
| Active participants |
1 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
1 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2020-08-27 |
| Name of individual signing |
RICHARD SMITH |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2020-08-27 |
| Name of individual signing |
RICHARD SMITH |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2014-01-29
|
| Business code |
621610
|
| Sponsor’s telephone number |
8456103432
|
| Plan
sponsor’s DBA name |
GRISWOLD HOME CARE
|
| Plan sponsor’s mailing address |
15 COLEMAN DR, CAMPBELL HALL, NY, 109162642
|
| Plan sponsor’s
address |
15 RAILROAD AVE, CHESTER, NY, 10918
|
Number of participants as of the end of the plan year
| Active participants |
1 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
1 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Employer/plan sponsor |
| Date |
2020-08-27 |
| Name of individual signing |
RICHARD SMITH |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
