|
LIFELINE HOMECARE INC CBS BENEFIT PLAN
|
2023
|
611161293
|
2024-04-29
|
LIFELINE HOMECARE INC
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2022-11-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
6066784032
|
| Plan sponsor’s
address |
246 POPLAR AVE STE 3, SOMERSET, KY, 42503
|
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 |
2024-04-29 |
| Name of individual signing |
SHAWNA BURTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LIFELINE HOMECARE INC CBS BENEFIT PLAN
|
2022
|
611161293
|
2023-12-27
|
LIFELINE HOMECARE INC
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2022-11-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
6066784032
|
| Plan sponsor’s
address |
246 POPLAR AVE STE 3, SOMERSET, KY, 42503
|
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 |
2023-12-27 |
| Name of individual signing |
SHAWNA BURTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC.
|
2020
|
611161293
|
2021-10-12
|
LIFELINE HOMECARE, INC.
|
85
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1996-04-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
6066784032
|
| Plan sponsor’s
address |
PO BOX 429, SOMERSET, KY, 425020429
|
Signature of
| Role |
Plan administrator |
| Date |
2021-10-12 |
| Name of individual signing |
JAMES T. WILSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC.
|
2019
|
611161293
|
2020-10-05
|
LIFELINE HOMECARE, INC.
|
84
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1996-04-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
6066784032
|
| Plan sponsor’s
address |
PO BOX 429, SOMERSET, KY, 425020429
|
Signature of
| Role |
Plan administrator |
| Date |
2020-10-05 |
| Name of individual signing |
JAMES T. WILSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC.
|
2018
|
611161293
|
2019-10-10
|
LIFELINE HOMECARE, INC.
|
74
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1996-04-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
6066784032
|
| Plan sponsor’s
address |
PO BOX 429, SOMERSET, KY, 425020429
|
Signature of
| Role |
Plan administrator |
| Date |
2019-10-10 |
| Name of individual signing |
JAMES T. WILSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
