STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2023
|
721367773
|
2024-07-01
|
STATCARE PLLC
|
60
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648
|
Signature of
Role |
Plan administrator |
Date |
2024-06-29 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-06-29 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2022
|
721367773
|
2023-05-22
|
STATCARE PLLC
|
58
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648
|
Signature of
Role |
Plan administrator |
Date |
2023-05-17 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-05-17 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2021
|
721367773
|
2022-09-26
|
STATCARE PLLC
|
57
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648
|
Signature of
Role |
Plan administrator |
Date |
2022-09-16 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2020
|
721367773
|
2021-09-28
|
STATCARE PLLC
|
55
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648
|
Signature of
Role |
Plan administrator |
Date |
2021-09-26 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-09-26 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2019
|
721367773
|
2020-09-09
|
STATCARE PLLC
|
50
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648
|
Signature of
Role |
Plan administrator |
Date |
2020-09-06 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-09-06 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2018
|
721367773
|
2019-07-14
|
STATCARE PLLC
|
51
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648
|
Signature of
Role |
Plan administrator |
Date |
2019-07-14 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-07-14 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2017
|
721367773
|
2018-07-09
|
STATCARE PLLC
|
57
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648
|
Signature of
Role |
Plan administrator |
Date |
2018-06-27 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-27 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2016
|
721367773
|
2017-07-26
|
STATCARE PLLC
|
57
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648
|
Signature of
Role |
Plan administrator |
Date |
2017-07-20 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-20 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2015
|
721367773
|
2016-07-23
|
STATCARE PLLC
|
56
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
P O BOX 1909, MCCOMB, MS, 39649
|
Signature of
Role |
Plan administrator |
Date |
2016-07-17 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-17 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE PLLC 401K PROFIT SHARING PLAN
|
2014
|
721367773
|
2015-06-19
|
STATCARE PLLC
|
41
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6012501122
|
Plan sponsor’s
address |
P O BOX 1909, MCCOMB, MS, 39649
|
Signature of
Role |
Plan administrator |
Date |
2015-06-15 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-06-15 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2013
|
721367773
|
2014-06-03
|
STATCARE PLLC
|
36
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/03/20140603084508P040424088929003.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2008-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
6012501122 |
Plan sponsor’s
address |
P O BOX 1909, MCCOMB, MS, 39649 |
Signature of
Role |
Plan administrator |
Date |
2014-05-22 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-05-22 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2012
|
721367773
|
2013-05-24
|
STATCARE PLLC
|
34
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/05/24/20130524181503P030012388994006.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2008-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
6012501122 |
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648 |
Signature of
Role |
Plan administrator |
Date |
2013-05-10 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-05-10 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2011
|
721367773
|
2012-07-18
|
STATCARE PLLC
|
33
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/18/20120718081506P040000497523004.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2008-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
6012501122 |
Plan sponsor’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648 |
Plan administrator’s name and address
Administrator’s EIN |
721367773 |
Plan administrator’s name |
STATCARE PLLC |
Plan administrator’s
address |
1017 DELAWARE AVENUE, MCCOMB, MS, 39648 |
Administrator’s telephone number |
6012501122 |
Signature of
Role |
Plan administrator |
Date |
2012-07-15 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-15 |
Name of individual signing |
JOHN A WATSON DO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2010
|
721367773
|
2011-04-18
|
STATCARE, PLLC
|
33
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/18/20110418101046P040206733840001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2008-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
6012501122 |
Plan sponsor’s
address |
P. O. BOX 1909, MCCOMB, MS, 39649 |
Plan administrator’s name and address
Administrator’s EIN |
721367773 |
Plan administrator’s name |
STATCARE, PLLC |
Plan administrator’s
address |
P. O. BOX 1909, MCCOMB, MS, 39649 |
Administrator’s telephone number |
6012501122 |
Signature of
Role |
Plan administrator |
Date |
2011-04-18 |
Name of individual signing |
ANDY WATSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-04-18 |
Name of individual signing |
ANDY WATSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STATCARE, PLLC 401(K) PROFIT SHARING PLAN
|
2009
|
721367773
|
2010-08-12
|
STATCARE, PLLC
|
32
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/08/12/20100812112317P070000315205001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2008-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
6012501122 |
Plan sponsor’s
address |
P. O. BOX 1909, MCCOMB, MS, 39649 |
Plan administrator’s name and address
Administrator’s EIN |
721367773 |
Plan administrator’s name |
STATCARE, PLLC |
Plan administrator’s
address |
P. O. BOX 1909, MCCOMB, MS, 39649 |
Administrator’s telephone number |
6012501122 |
Signature of
Role |
Plan administrator |
Date |
2010-08-12 |
Name of individual signing |
ANDY WATSON, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-08-12 |
Name of individual signing |
ANDY WATSON, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|