|
TUPELO EYE CENTER OPTICAL SHOP 401(K) PLAN
|
2012
|
640522732
|
2013-05-03
|
TUPELO EYE CENTER OPTICAL SHOP
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2000-02-01
|
| Business code |
446130
|
| Sponsor’s telephone number |
6628443814
|
| Plan sponsor’s mailing address |
610 BRUNSON, TUPELO, MS, 38801
|
| Plan sponsor’s
address |
610 BRUNSON, TUPELO, MS, 38801
|
Plan administrator’s name and address
| Administrator’s EIN |
640522732 |
| Plan administrator’s name |
TUPELO EYE CENTER OPTICAL SHOP |
| Plan administrator’s
address |
610 BRUNSON, TUPELO, MS, 38801 |
| Administrator’s telephone number |
6628443814 |
Number of participants as of the end of the plan year
| Active participants |
6 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
1 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
7 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2013-05-03 |
| Name of individual signing |
WILLIAM BRAWNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-05-03 |
| Name of individual signing |
WILLIAM BRAWNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
TUPELO EYE CENTER OPTICAL SHOP 401(K) PLAN
|
2011
|
640522732
|
2012-03-28
|
TUPELO EYE CENTER OPTICAL SHOP
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2000-02-01
|
| Business code |
446130
|
| Sponsor’s telephone number |
6628443814
|
| Plan sponsor’s mailing address |
610 BRUNSON, TUPELO, MS, 38801
|
| Plan sponsor’s
address |
610 BRUNSON, TUPELO, MS, 38801
|
Plan administrator’s name and address
| Administrator’s EIN |
640522732 |
| Plan administrator’s name |
TUPELO EYE CENTER OPTICAL SHOP |
| Plan administrator’s
address |
610 BRUNSON, TUPELO, MS, 38801 |
| Administrator’s telephone number |
6628443814 |
Number of participants as of the end of the plan year
| Active participants |
7 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
2 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
9 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2012-03-28 |
| Name of individual signing |
WILLIAM BRAWNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
TUPELO EYE CENTER OPTICAL SHOP 401(K) PLAN
|
2010
|
640522732
|
2011-04-11
|
TUPELO EYE CENTER OPTICAL SHOP
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2000-02-01
|
| Business code |
446130
|
| Sponsor’s telephone number |
6628443814
|
| Plan sponsor’s mailing address |
610 BRUNSON, TUPELO, MS, 38801
|
| Plan sponsor’s
address |
610 BRUNSON, TUPELO, MS, 38801
|
Plan administrator’s name and address
| Administrator’s EIN |
640522732 |
| Plan administrator’s name |
TUPELO EYE CENTER OPTICAL SHOP |
| Plan administrator’s
address |
610 BRUNSON, TUPELO, MS, 38801 |
| Administrator’s telephone number |
6628443814 |
Number of participants as of the end of the plan year
| Active participants |
7 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
2 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
9 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-04-11 |
| Name of individual signing |
WILLIAM BRAWNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
TUPELO EYE CENTER OPTICAL SHOP 401(K) PLAN
|
2009
|
640522732
|
2010-04-27
|
TUPELO EYE CENTER OPTICAL SHOP
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2000-02-01
|
| Business code |
446130
|
| Sponsor’s telephone number |
6628443814
|
| Plan sponsor’s mailing address |
610 BRUNSON, TUPELO, MS, 38801
|
| Plan sponsor’s
address |
610 BRUNSON, TUPELO, MS, 38801
|
Plan administrator’s name and address
| Administrator’s EIN |
640522732 |
| Plan administrator’s name |
TUPELO EYE CENTER OPTICAL SHOP |
| Plan administrator’s
address |
610 BRUNSON, TUPELO, MS, 38801 |
| Administrator’s telephone number |
6628443814 |
Number of participants as of the end of the plan year
| Active participants |
8 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
1 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
9 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-04-27 |
| Name of individual signing |
WILLIAM BRAWNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
