|
HAZARD EXPRESS CBS BENEFIT PLAN
|
2021
|
341051799
|
2022-12-29
|
HAZARD EXPRESS
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2021-01-01
|
| Business code |
484110
|
| Sponsor’s telephone number |
6064362314
|
| Plan sponsor’s
address |
931 STATE ROUTE 80 W, HAZARD, KY, 41701
|
Plan administrator’s name and address
| Administrator’s EIN |
846429706 |
| Plan administrator’s name |
SHAWNA BURTON |
| Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number |
5026954700 |
Signature of
| Role |
Plan administrator |
| Date |
2022-12-29 |
| Name of individual signing |
SHAWNA BURTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
HAZARD EXPRESS CBS BENEFIT PLAN
|
2020
|
341051799
|
2021-12-14
|
HAZARD EXPRESS
|
3
|
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2021-01-01
|
| Business code |
484110
|
| Sponsor’s telephone number |
6064362314
|
| Plan sponsor’s
address |
931 KY-80, HAZARD, KY, 41701
|
Plan administrator’s name and address
| Administrator’s EIN |
846429706 |
| Plan administrator’s name |
SHAWNA BURTON |
| Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number |
5026954700 |
Signature of
| Role |
Plan administrator |
| Date |
2021-12-14 |
| Name of individual signing |
SHAWNA BURTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
