EMPLOYEE MEDICAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2015
|
640616673
|
2017-01-18
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
115
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Signature of
Role |
Plan administrator |
Date |
2017-01-18 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-01-18 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE MEDICAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2014
|
640616673
|
2016-01-13
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
91
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Signature of
Role |
Plan administrator |
Date |
2016-01-13 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-01-13 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE MEDICAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2013
|
640616673
|
2015-01-06
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
73
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Signature of
Role |
Plan administrator |
Date |
2015-01-06 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-06 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE DENTAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2013
|
640616673
|
2015-01-06
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
75
|
|
File |
View Page
|
Three-digit plan number (PN) |
515
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Signature of
Role |
Plan administrator |
Date |
2015-01-06 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-06 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE MEDICAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2012
|
640616673
|
2014-01-10
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
77
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Signature of
Role |
Plan administrator |
Date |
2014-01-10 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-01-10 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE DENTAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2012
|
640616673
|
2014-01-10
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
86
|
|
File |
View Page
|
Three-digit plan number (PN) |
515
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Signature of
Role |
Plan administrator |
Date |
2014-01-10 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-01-10 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE MEDICAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2011
|
640616673
|
2012-12-12
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
90
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Plan administrator’s name and address
Administrator’s EIN |
640616673 |
Plan administrator’s name |
MISKELLY FURNITURE WAREHOUSE, INC. |
Plan administrator’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655 |
Administrator’s telephone number |
6019396288 |
Signature of
Role |
Plan administrator |
Date |
2012-12-12 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-12-12 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE DENTAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2011
|
640616673
|
2012-12-12
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
92
|
|
File |
View Page
|
Three-digit plan number (PN) |
515
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Plan administrator’s name and address
Administrator’s EIN |
640616673 |
Plan administrator’s name |
MISKELLY FURNITURE WAREHOUSE, INC. |
Plan administrator’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655 |
Administrator’s telephone number |
6019396288 |
Signature of
Role |
Plan administrator |
Date |
2012-12-12 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-12-12 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE MEDICAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2010
|
640616673
|
2011-12-30
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
91
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Plan administrator’s name and address
Administrator’s EIN |
640616673 |
Plan administrator’s name |
MISKELLY FURNITURE WAREHOUSE, INC. |
Plan administrator’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655 |
Administrator’s telephone number |
6019396288 |
Signature of
Role |
Plan administrator |
Date |
2011-12-30 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-12-30 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE DENTAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2010
|
640616673
|
2011-12-30
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
91
|
|
File |
View Page
|
Three-digit plan number (PN) |
515
|
Effective date of plan |
1996-09-01
|
Business code |
442110
|
Sponsor’s telephone number |
6019396288
|
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655
|
Plan administrator’s name and address
Administrator’s EIN |
640616673 |
Plan administrator’s name |
MISKELLY FURNITURE WAREHOUSE, INC. |
Plan administrator’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655 |
Administrator’s telephone number |
6019396288 |
Signature of
Role |
Plan administrator |
Date |
2011-12-30 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-12-30 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE MEDICAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2009
|
640616673
|
2011-01-12
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
89
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/12/20110112163651P040001974530001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
1996-09-01 |
Business code |
442110 |
Sponsor’s telephone number |
6019396288 |
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655 |
Plan administrator’s name and address
Administrator’s EIN |
640616673 |
Plan administrator’s name |
MISKELLY FURNITURE WAREHOUSE, INC. |
Plan administrator’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655 |
Administrator’s telephone number |
6019396288 |
Signature of
Role |
Plan administrator |
Date |
2011-01-12 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-12 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE DENTAL BENEFIT PLAN FOR MISKELLY FURNITURE
|
2009
|
640616673
|
2011-01-12
|
MISKELLY FURNITURE WAREHOUSE, INC.
|
99
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/12/20110112163341P040059884848001.pdf |
Three-digit plan number (PN) |
515 |
Effective date of plan |
1996-09-01 |
Business code |
442110 |
Sponsor’s telephone number |
6019396288 |
Plan sponsor’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655 |
Plan administrator’s name and address
Administrator’s EIN |
640616673 |
Plan administrator’s name |
MISKELLY FURNITURE WAREHOUSE, INC. |
Plan administrator’s
address |
101 AIRPORT ROAD, PEARL, MS, 392086655 |
Administrator’s telephone number |
6019396288 |
Signature of
Role |
Plan administrator |
Date |
2011-01-12 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-12 |
Name of individual signing |
OSCAR MISKELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|