|
GERALD W. SEGRAVES, D.D.S., P.A. EMPLOYEES' PROFIT SHARING PLAN AND TRUST
|
2012
|
640591766
|
2013-11-11
|
GERALD W. SEGRAVES, D.D.S., P.A.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1976-11-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2288325300
|
| Plan sponsor’s
address |
15382-A ST. CHARLES STREET, GULFPORT, MS, 395033152
|
Signature of
| Role |
Plan administrator |
| Date |
2013-11-11 |
| Name of individual signing |
GERALD W. SEGRAVES, DDS, PRESIDENT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GERALD W. SEGRAVES, D.D.S., P.A. EMPLOYEES' PROFIT SHARING PLAN AND TRUST
|
2011
|
640591766
|
2012-12-14
|
GERALD W. SEGRAVES, D.D.S., P.A.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1976-11-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2288325300
|
| Plan sponsor’s
address |
15382-A ST. CHARLES STREET, GULFPORT, MS, 395033152
|
Plan administrator’s name and address
| Administrator’s EIN |
640591766 |
| Plan administrator’s name |
GERALD W. SEGRAVES, D.D.S., P.A. |
| Plan administrator’s
address |
15382-A ST. CHARLES STREET, GULFPORT, MS, 395033152 |
| Administrator’s telephone number |
2288325300 |
Signature of
| Role |
Plan administrator |
| Date |
2012-12-14 |
| Name of individual signing |
GERALD W. SEGRAVES, DDS, PRESIDENT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GERALD W. SEGRAVES, D.D.S., P.A. EMPLOYEES' PROFIT SHARING PLAN AND TRUST
|
2010
|
640591766
|
2012-02-03
|
GERALD W. SEGRAVES, D.D.S., P.A.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1976-11-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2288325300
|
| Plan sponsor’s
address |
15382-A ST. CHARLES STREET, GULFPORT, MS, 395033152
|
Plan administrator’s name and address
| Administrator’s EIN |
640591766 |
| Plan administrator’s name |
GERALD W. SEGRAVES, D.D.S., P.A. |
| Plan administrator’s
address |
15382-A ST. CHARLES STREET, GULFPORT, MS, 395033152 |
| Administrator’s telephone number |
2288325300 |
Signature of
| Role |
Plan administrator |
| Date |
2012-02-03 |
| Name of individual signing |
GERALD W. SEGRAVES, DDS, PRESIDENT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GERALD W. SEGRAVES, D.D.S., P.A. EMPLOYEES' PROFIT SHARING PLAN AND TRUST
|
2009
|
640591766
|
2010-12-07
|
GERALD W. SEGRAVES, D.D.S., P.A.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1976-11-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2288325300
|
| Plan sponsor’s
address |
15382-A ST. CHARLES STREET, GULFPORT, MS, 395033152
|
Plan administrator’s name and address
| Administrator’s EIN |
640591766 |
| Plan administrator’s name |
GERALD W. SEGRAVES, D.D.S., P.A. |
| Plan administrator’s
address |
15382-A ST. CHARLES STREET, GULFPORT, MS, 395033152 |
| Administrator’s telephone number |
2288325300 |
Signature of
| Role |
Plan administrator |
| Date |
2010-12-07 |
| Name of individual signing |
GERALD W. SEGRAVES, DDS, PRESIDENT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
