|
JERALD M. FORD, M.D., P.S.C. PROFIT SHARING PLAN
|
2012
|
611147344
|
2013-06-13
|
JERALD M. FORD, M.D., P.S.C.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1989-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6063251200
|
| Plan sponsor’s
address |
PO BOX 2527, ASHLAND, KY, 411052527
|
Signature of
| Role |
Plan administrator |
| Date |
2013-06-13 |
| Name of individual signing |
JERALD M. FORD, MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-06-13 |
| Name of individual signing |
JERALD M. FORD, MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JERALD M. FORD, M.D., P.S.C. PROFIT SHARING PLAN
|
2011
|
611147344
|
2012-07-16
|
JERALD M. FORD, M.D., P.S.C.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1989-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6063251200
|
| Plan sponsor’s
address |
PO BOX 2527, ASHLAND, KY, 411052527
|
Plan administrator’s name and address
| Administrator’s EIN |
611147344 |
| Plan administrator’s name |
JERALD M. FORD, M.D., P.S.C. |
| Plan administrator’s
address |
PO BOX 2527, ASHLAND, KY, 411052527 |
| Administrator’s telephone number |
6063251200 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-13 |
| Name of individual signing |
JERALD M. FORD, MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-07-13 |
| Name of individual signing |
JERALD M. FORD, MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JERALD M. FORD, M.D., P.S.C. PROFIT SHARING PLAN
|
2010
|
611147344
|
2011-10-04
|
JERALD M. FORD, M.D., P.S.C.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1989-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6063251200
|
| Plan sponsor’s
address |
PO BOX 2527, ASHLAND, KY, 411052527
|
Plan administrator’s name and address
| Administrator’s EIN |
611147344 |
| Plan administrator’s name |
JERALD M. FORD, M.D., P.S.C. |
| Plan administrator’s
address |
PO BOX 2527, ASHLAND, KY, 411052527 |
| Administrator’s telephone number |
6063251200 |
Signature of
| Role |
Plan administrator |
| Date |
2011-10-04 |
| Name of individual signing |
JERALD M. FORD, MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JERALD M. FORD, M.D., P.S.C. PROFIT SHARING PLAN
|
2009
|
611147344
|
2010-07-22
|
JERALD M. FORD, M.D., P.S.C.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1989-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6063251200
|
| Plan sponsor’s
address |
PO BOX 2527, ASHLAND, KY, 411052527
|
Plan administrator’s name and address
| Administrator’s EIN |
611147344 |
| Plan administrator’s name |
JERALD M. FORD, M.D., P.S.C. |
| Plan administrator’s
address |
PO BOX 2527, ASHLAND, KY, 411052527 |
| Administrator’s telephone number |
6063251200 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-22 |
| Name of individual signing |
JERALD M. FORD, MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-07-22 |
| Name of individual signing |
JERALD M. FORD, MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
