|
DR. GARY A. NELSON, P.A. PROFIT SHARING PLAN
|
2013
|
640592745
|
2014-05-06
|
DR. GARY A. NELSON, P.A.
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1997-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6019247994
|
| Plan sponsor’s
address |
102 SUSAN CIRCLE, CLINTON, MS, 39056
|
Signature of
| Role |
Plan administrator |
| Date |
2014-05-06 |
| Name of individual signing |
KEVIN NELSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2014-05-06 |
| Name of individual signing |
KEVIN NELSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
DR. GARY A. NELSON, P.A. PROFIT SHARING PLAN
|
2010
|
640592745
|
2011-09-15
|
DR. GARY A. NELSON, P.A.
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1997-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6019247994
|
| Plan sponsor’s mailing address |
P.O. BOX 1319, CLINTON, MS, 390601319
|
| Plan sponsor’s
address |
1001 HIGHWAY 80 EAST, CLINTON, MS, 390601319
|
Plan administrator’s name and address
| Administrator’s EIN |
640592745 |
| Plan administrator’s name |
DR. GARY A. NELSON, P.A. |
| Plan administrator’s
address |
P.O. BOX 1319, CLINTON, MS, 390601319 |
| Administrator’s telephone number |
6019247994 |
Number of participants as of the end of the plan year
| Active participants |
1 |
| Retired or separated participants receiving
benefits |
1 |
| Other
retired or separated participants entitled to future benefits |
7 |
| 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 |
2011-09-15 |
| Name of individual signing |
GARY A. NELSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-09-15 |
| Name of individual signing |
GARY A. NELSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
DR. GARY A. NELSON, P.A. PROFIT SHARING PLAN
|
2009
|
640592745
|
2010-09-30
|
DR. GARY A. NELSON, P.A.
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1997-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6019247994
|
| Plan sponsor’s mailing address |
P.O. BOX 1319, CLINTON, MS, 390601319
|
| Plan sponsor’s
address |
1001 HIGHWAY 80 EAST, CLINTON, MS, 390601319
|
Plan administrator’s name and address
| Administrator’s EIN |
640592745 |
| Plan administrator’s name |
DR. GARY A. NELSON, P.A. |
| Plan administrator’s
address |
P.O. BOX 1319, CLINTON, MS, 390601319 |
| Administrator’s telephone number |
6019247994 |
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 |
3 |
| 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 |
10 |
| 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 |
2010-09-30 |
| Name of individual signing |
GARY A. NELSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-09-30 |
| Name of individual signing |
GARY A. NELSON, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
