|
TRI-STATE EMPLOYERS GROUP RETIREMENT SAVINGS PLAN
|
2013
|
611399402
|
2014-06-04
|
TRI-STATE EMPLOYERS GROUP, INC.
|
26
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2003-01-01
|
| Business code |
561300
|
| Sponsor’s telephone number |
8594427050
|
| Plan sponsor’s
address |
4150 ALEXANDRIA PIKE, SUITE 114, COLD SPRING, KY, 41076
|
Signature of
| Role |
Plan administrator |
| Date |
2014-06-04 |
| Name of individual signing |
PAMELA S BANTA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2014-06-04 |
| Name of individual signing |
PAMELA S BANTA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
TRI-STATE EMPLOYERS GROUP RETIREMENT SAVINGS PLAN
|
2013
|
611399402
|
2014-10-07
|
TRI-STATE EMPLOYERS GROUP, INC.
|
26
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2003-01-01
|
| Business code |
561300
|
| Sponsor’s telephone number |
8594427050
|
| Plan sponsor’s
address |
4150 ALEXANDRIA PIKE, SUITE 114, COLD SPRING, KY, 41076
|
Signature of
| Role |
Plan administrator |
| Date |
2014-10-07 |
| Name of individual signing |
PAMELA BANTA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2014-10-07 |
| Name of individual signing |
PAMELA BANTA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
TRI-STATE EMPLOYERS GROUP RETIREMENT SAVINGS PLAN
|
2012
|
611399402
|
2013-06-26
|
TRI-STATE EMPLOYERS GROUP, INC.
|
25
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2003-01-01
|
| Business code |
561300
|
| Sponsor’s telephone number |
8594427050
|
| Plan sponsor’s
address |
4150 ALEXANDRIA PIKE, SUITE 114, COLD SPRING, KY, 41076
|
Signature of
| Role |
Plan administrator |
| Date |
2013-06-26 |
| Name of individual signing |
PAMELA BANTA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
TRI-STATE EMPLOYERS GROUP RETIREMENT SAVINGS PLAN
|
2011
|
611399402
|
2012-05-31
|
TRI-STATE EMPLOYERS GROUP, INC.
|
28
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2003-01-01
|
| Business code |
561300
|
| Sponsor’s telephone number |
8594427050
|
| Plan sponsor’s
address |
4150 ALEXANDRIA PIKE, SUITE 114, COLD SPRING, KY, 41076
|
Plan administrator’s name and address
| Administrator’s EIN |
611399402 |
| Plan administrator’s name |
TRI-STATE EMPLOYERS GROUP, INC. |
| Plan administrator’s
address |
4150 ALEXANDRIA PIKE, SUITE 114, COLD SPRING, KY, 41076 |
| Administrator’s telephone number |
8594427050 |
Signature of
| Role |
Plan administrator |
| Date |
2012-05-31 |
| Name of individual signing |
PAMELA BANTA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
TRI-STATE EMPLOYERS GROUP RETIREMENT SAVINGS PLAN
|
2010
|
611399402
|
2011-10-18
|
TRI-STATE EMPLOYERS GROUP, INC.
|
26
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2003-01-01
|
| Business code |
561300
|
| Sponsor’s telephone number |
8594427050
|
| Plan sponsor’s
address |
4150 ALEXANDRIA PIKE, SUITE 114, COLD SPRING, KY, 41076
|
Plan administrator’s name and address
| Administrator’s EIN |
611399402 |
| Plan administrator’s name |
TRI-STATE EMPLOYERS GROUP, INC. |
| Plan administrator’s
address |
4150 ALEXANDRIA PIKE, SUITE 114, COLD SPRING, KY, 41076 |
| Administrator’s telephone number |
8594427050 |
Signature of
| Role |
Plan administrator |
| Date |
2011-10-18 |
| Name of individual signing |
PAMELA BANTA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
