|
LUCAS SURGICAL GROUP, P.A. PROFIT SHARING PLAN
|
2011
|
640630246
|
2012-09-04
|
LUCAS SURGICAL GROUP, P.A.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1980-04-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6624534641
|
| Plan sponsor’s mailing address |
P. O. BOX 1974, GREENWOOD, MS, 38930
|
| Plan sponsor’s
address |
PHYSICIANS AND SURGEONS BUILDING, GREENWOOD, MS, 38930
|
Plan administrator’s name and address
| Administrator’s EIN |
640630246 |
| Plan administrator’s name |
LUCAS SURGICAL GROUP, P.A. |
| Plan administrator’s
address |
P. O. BOX 1974, GREENWOOD, MS, 38930 |
| Administrator’s telephone number |
6624534641 |
Number of participants as of the end of the plan year
| Active participants |
0 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| 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 |
0 |
| 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 |
2012-09-04 |
| Name of individual signing |
JOHN F. LUCAS, III, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LUCAS SURGICAL GROUP, P.A. PROFIT SHARING PLAN
|
2011
|
640630246
|
2012-07-10
|
LUCAS SURGICAL GROUP, P.A.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1980-04-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6624534641
|
| Plan sponsor’s mailing address |
P. O. BOX 1974, GREENWOOD, MS, 38930
|
| Plan sponsor’s
address |
PHYSICIANS AND SURGEONS BUILDING, GREENWOOD, MS, 38930
|
Plan administrator’s name and address
| Administrator’s EIN |
640630246 |
| Plan administrator’s name |
LUCAS SURGICAL GROUP, P.A. |
| Plan administrator’s
address |
P. O. BOX 1974, GREENWOOD, MS, 38930 |
| Administrator’s telephone number |
6624534641 |
Number of participants as of the end of the plan year
| Active participants |
2 |
| Retired or separated participants receiving
benefits |
1 |
| 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 |
4 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-10 |
| Name of individual signing |
JOHN F. LUCAS, III, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LUCAS SURGICAL GROUP, P.A. PROFIT SHARING PLAN
|
2010
|
640630246
|
2011-05-06
|
LUCAS SURGICAL GROUP, P.A.
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1980-04-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6624534641
|
| Plan sponsor’s mailing address |
P. O. BOX 1974, GREENWOOD, MS, 38930
|
| Plan sponsor’s
address |
PHYSICIANS AND SURGEONS BUILDING, GREENWOOD, MS, 38930
|
Plan administrator’s name and address
| Administrator’s EIN |
640630246 |
| Plan administrator’s name |
LUCAS SURGICAL GROUP, P.A. |
| Plan administrator’s
address |
P. O. BOX 1974, GREENWOOD, MS, 38930 |
| Administrator’s telephone number |
6624534641 |
Number of participants as of the end of the plan year
| Active participants |
7 |
| Retired or separated participants receiving
benefits |
1 |
| Other
retired or separated participants entitled to future benefits |
0 |
| 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 |
8 |
| 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 |
2011-05-05 |
| Name of individual signing |
JOHN F. LUCAS, III, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LUCAS SURGICAL GROUP, P.A. PROFIT SHARING PLAN
|
2009
|
640630246
|
2010-09-08
|
LUCAS SURGICAL GROUP, P.A.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1980-04-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6624534641
|
| Plan sponsor’s mailing address |
P. O. BOX 1974, GREENWOOD, MS, 38930
|
| Plan sponsor’s
address |
PHYSICIANS AND SURGEONS BUILDING, GREENWOOD, MS, 38930
|
Plan administrator’s name and address
| Administrator’s EIN |
640630246 |
| Plan administrator’s name |
LUCAS SURGICAL GROUP, P.A. |
| Plan administrator’s
address |
P. O. BOX 1974, GREENWOOD, MS, 38930 |
| Administrator’s telephone number |
6624534641 |
Number of participants as of the end of the plan year
| Active participants |
6 |
| Retired or separated participants receiving
benefits |
1 |
| Other
retired or separated participants entitled to future benefits |
0 |
| 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 |
6 |
| 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 |
2010-09-08 |
| Name of individual signing |
JOHN F. LUCAS, III, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
