UNIVERSAL PHOTONICS, INC. LIFE INSURANCE PLAN
|
2023
|
112665147
|
2024-10-15
|
UNIVERSAL PHOTONICS, INC
|
144
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2011-04-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-10-15 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNIVERSAL PHOTONICS, INC
|
2023
|
112665147
|
2024-05-02
|
UNIVERSAL PHOTONICS, INC
|
93
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2015-01-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-05-02 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-05-02 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2024-05-02 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNIVERSAL PHOTONICS INC. LIFE INSURANCE PLAN
|
2022
|
112665147
|
2023-11-07
|
UNIVERSAL PHOTONICS
|
126
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2011-04-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-11-07 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-11-07 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2023-11-07 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNIVERSAL PHOTONOCS, INC. LONG TERM DISABILITY INSURANCE PLAN
|
2022
|
112665147
|
2024-03-21
|
UNIVERSAL PHOTONICS, INC
|
142
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-10-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan administrator’s name and address
Administrator’s EIN |
112665147 |
Plan administrator’s name |
UNIVERSAL PHOTONICS, INC |
Plan administrator’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202 |
Administrator’s telephone number |
5169354000 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-03-21 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-03-21 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2024-03-21 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNIVERSAL PHOTONICS, INC.
|
2022
|
112665147
|
2024-03-21
|
UNIVERSAL PHOTONICS, INC
|
66
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2015-07-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-03-21 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-03-21 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2024-03-21 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNIVERSAL PHOTONICS, INC
|
2022
|
112665147
|
2023-07-12
|
UNIVERSAL PHOTONICS, INC
|
80
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2015-01-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-07-12 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-07-12 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2023-07-12 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNIVERSAL PHOTONICS INC. LIFE INSURANCE PLAN
|
2021
|
112665147
|
2022-10-26
|
UNIVERSAL PHOTONICS
|
128
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2011-04-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-10-26 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-10-26 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2022-10-26 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNIVERSAL PHOTONICS, INC. LONG TERM DISABILITY INSURANCE PLAN
|
2021
|
112665147
|
2023-04-05
|
UNIVERSAL PHOTONICS, INC
|
115
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-10-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan administrator’s name and address
Administrator’s EIN |
112665147 |
Plan administrator’s name |
UNIVERSAL PHOTONICS, INC |
Plan administrator’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202 |
Administrator’s telephone number |
5169354000 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-04-05 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-04-05 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2023-04-05 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNIVERSAL PHOTONICS, INC
|
2021
|
112665147
|
2023-01-31
|
UNIVERSAL PHOTONICS, INC
|
61
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2015-07-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-01-31 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-01-31 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2023-01-31 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNIVERSAL PHOTONICS, INC
|
2021
|
112665147
|
2022-07-06
|
UNIVERSAL PHOTONICS, INC.
|
78
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2015-01-01
|
Business code |
424990
|
Sponsor’s telephone number |
5169354000
|
Plan sponsor’s mailing address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Plan sponsor’s
address |
85 JETSON LN, CENTRAL ISLIP, NY, 117221202
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-07-06 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-07-06 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2022-07-06 |
Name of individual signing |
NEIL JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|