ELLEN MELLOW MD 401(K) PROFIT SHARING PLAN AND TRUST
|
2018
|
133896309
|
2019-03-29
|
ELLEN MELLOW, MD
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2128384114
|
Plan sponsor’s
address |
110 E 59TH STREET SUITE 10B, NEW YORK, NY, 10022
|
Signature of
Role |
Plan administrator |
Date |
2019-03-29 |
Name of individual signing |
ELLEN MELLOW |
|
|
ELLEN MELLOW MD 401K PSP AND TRUST
|
2017
|
133896309
|
2018-07-05
|
ELLEN MELLOW MD
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2128380099
|
Plan sponsor’s
address |
110 E 59TH ST FL 10B, NEW YORK, NY, 100222221
|
Signature of
Role |
Plan administrator |
Date |
2018-07-05 |
Name of individual signing |
ELLEN MELLOW |
|
|
ELLEN MELLOW MD 401K PSP AND TRUST
|
2016
|
133896309
|
2017-07-30
|
ELLEN MELLOW MD
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9172575602
|
Plan sponsor’s
address |
110 E 59TH ST FL 10B, NEW YORK, NY, 100221365
|
Signature of
Role |
Plan administrator |
Date |
2017-07-30 |
Name of individual signing |
ELLEN MELLOW |
|
|
ELLEN MELLOW MD 401K PSP AND TRUST
|
2015
|
133896309
|
2016-07-17
|
ELLEN MELLOW MD
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9172575602
|
Plan sponsor’s
address |
110 E 59TH ST FL 10B, NEW YORK, NY, 100221365
|
Signature of
Role |
Plan administrator |
Date |
2016-07-17 |
Name of individual signing |
ELLEN MELLOW |
|
|
ELLEN MELLOW MD 401K PSP AND TRUST
|
2014
|
133896309
|
2015-07-29
|
ELLEN MELLOW MD
|
6
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9172575602
|
Plan sponsor’s
address |
110 E 59TH ST FL 10B, NEW YORK, NY, 100221365
|
Signature of
Role |
Plan administrator |
Date |
2015-07-28 |
Name of individual signing |
ELLEN MELLOW |
|
|
ELLEN MELLOW MD 401K PSP AND TRUST
|
2013
|
133896309
|
2014-07-22
|
ELLEN MELLOW MD
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9172575602
|
Plan sponsor’s
address |
110 E 59TH ST FL 10B, NEW YORK, NY, 100221365
|
Signature of
Role |
Plan administrator |
Date |
2014-07-22 |
Name of individual signing |
ELLEN MELLOW |
|
|
ELLEN MELLOW MD 401K PSP AND TRUST
|
2012
|
133896309
|
2013-07-24
|
ELLEN MELLOW MD
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9172575602
|
Plan sponsor’s
address |
110 E 59TH ST FL 10B, ATTN ZHIBIN LI, NEW YORK, NY, 100221365
|
Signature of
Role |
Plan administrator |
Date |
2013-07-24 |
Name of individual signing |
ELLEN MELLOW |
|
|
ELLEN MELLOW MD 401K PSP AND TRUST
|
2011
|
133896309
|
2012-07-20
|
ELLEN MELLOW MD
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2128384114
|
Plan sponsor’s
address |
110 E 59TH ST FL 10B, ATTN ZHIBIN LI, NEW YORK, NY, 100221365
|
Plan administrator’s name and address
Administrator’s EIN |
133896309 |
Plan administrator’s name |
ELLEN MELLOW MD |
Plan administrator’s
address |
110 E 59TH ST FL 10B, ATTN ZHIBIN LI, NEW YORK, NY, 100221365 |
Administrator’s telephone number |
2128384114 |
Signature of
Role |
Plan administrator |
Date |
2012-07-20 |
Name of individual signing |
ZHIBIN LI |
|
|
ELLEN MELLOW MD 401(K) PROFIT SHARING PLAN AND TRUST
|
2010
|
133896309
|
2011-10-17
|
ELLEN MELLOW, MD
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2128384114
|
Plan sponsor’s
address |
110 E 59TH STREET SUITE 10B, NEW YORK, NY, 10022
|
Plan administrator’s name and address
Administrator’s EIN |
133896309 |
Plan administrator’s name |
ELLEN MELLOW, MD |
Plan administrator’s
address |
110 E 59TH STREET SUITE 10B, NEW YORK, NY, 10022 |
Administrator’s telephone number |
2128384114 |
Signature of
Role |
Plan administrator |
Date |
2011-10-17 |
Name of individual signing |
ELLEN MELLOW |
|
|