ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2020
|
640899283
|
2021-05-05
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2021-05-05 |
Name of individual signing |
TERESA LITTLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-05-05 |
Name of individual signing |
TERESA LITTLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2020
|
640899283
|
2021-05-05
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2021-05-05 |
Name of individual signing |
TERESA LITTLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-05-05 |
Name of individual signing |
TERESA LITTLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2019
|
640899283
|
2020-10-15
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2020-10-15 |
Name of individual signing |
MELISSA SAGLIME |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-10-15 |
Name of individual signing |
MELISSA SAGLIME |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2018
|
640899283
|
2019-09-16
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
28
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2019-09-16 |
Name of individual signing |
WILLIAM B SULLIVAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-09-16 |
Name of individual signing |
WILLIAM B SULLIVAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2017
|
640899283
|
2018-10-15
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2018-10-15 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-15 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2016
|
640899283
|
2017-10-12
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2017-10-12 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-10-12 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2015
|
640899283
|
2016-07-27
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2016-07-27 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-27 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2014
|
640899283
|
2015-10-15
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
19
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2015-10-15 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-15 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2013
|
640899283
|
2014-10-15
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-10-15 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
2012
|
640899283
|
2013-10-09
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012685051
|
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402
|
Signature of
Role |
Plan administrator |
Date |
2013-10-09 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-09 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG PLLC PROFIT SHARING PLAN
|
2011
|
640899283
|
2012-10-12
|
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC
|
15
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/12/20121012155133P030014565442001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
1999-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
6012685051 |
Plan sponsor’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402 |
Plan administrator’s name and address
Administrator’s EIN |
640899283 |
Plan administrator’s name |
ASTHMA & ALLERGY CLINIC OF HATTIESBURG, PLLC |
Plan administrator’s
address |
109 MILLSAPS DRIVE, SUITE C, HATTIESBURG, MS, 39402 |
Administrator’s telephone number |
6012685051 |
Signature of
Role |
Plan administrator |
Date |
2012-10-12 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-12 |
Name of individual signing |
JERRA ALLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|