MICHAEL C. MOLLESTON, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2012
|
640922102
|
2013-05-31
|
MICHAEL C. MOLLESTON, M.D., P.A.
|
7
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6014508000
|
Plan sponsor’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394045159
|
Signature of
Role |
Plan administrator |
Date |
2013-05-31 |
Name of individual signing |
MICHAEL MOLLESTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-05-31 |
Name of individual signing |
MICHAEL C. MOLLESTON M.D.P.A. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL C. MOLLESTON, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2012
|
640922102
|
2013-05-31
|
MICHAEL C. MOLLESTON, M.D., P.A.
|
7
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6014508000
|
Plan sponsor’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394045159
|
Signature of
Role |
Plan administrator |
Date |
2013-05-31 |
Name of individual signing |
MICHAEL MOLLESTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-05-31 |
Name of individual signing |
MICHAEL C. MOLLESTON M.D.P.A. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL C. MOLLESTON, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2012
|
640922102
|
2013-06-03
|
MICHAEL C. MOLLESTON, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6014508000
|
Plan sponsor’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394045159
|
Signature of
Role |
Plan administrator |
Date |
2013-06-03 |
Name of individual signing |
MICHAEL MOLLESTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL C. MOLLESTON, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2012
|
640922102
|
2013-06-03
|
MICHAEL C. MOLLESTON, M.D., P.A.
|
7
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6014508000
|
Plan sponsor’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394045159
|
Signature of
Role |
Plan administrator |
Date |
2013-06-03 |
Name of individual signing |
MICHAEL MOLLESTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL C. MOLLESTON, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2011
|
640922102
|
2012-03-12
|
MICHAEL C. MOLLESTON, M.D., P.A.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6014508000
|
Plan sponsor’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394045159
|
Plan administrator’s name and address
Administrator’s EIN |
640922102 |
Plan administrator’s name |
MICHAEL C. MOLLESTON, M.D., P.A. |
Plan administrator’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394085159 |
Administrator’s telephone number |
6014508000 |
Signature of
Role |
Plan administrator |
Date |
2012-03-12 |
Name of individual signing |
MICHAEL MOLLESTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-03-12 |
Name of individual signing |
MICHAEL C. MOLLESTON MDPA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL C. MOLLESTON, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2010
|
640922102
|
2011-03-22
|
MICHAEL C. MOLLESTON, M.D., P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6014508000
|
Plan sponsor’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394045159
|
Plan administrator’s name and address
Administrator’s EIN |
640922102 |
Plan administrator’s name |
MICHAEL C. MOLLESTON, M.D., P.A. |
Plan administrator’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394085159 |
Administrator’s telephone number |
6014508000 |
Signature of
Role |
Plan administrator |
Date |
2011-03-22 |
Name of individual signing |
MICHAEL MOLLESTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-03-22 |
Name of individual signing |
MICHAEL MOLLESTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MICHAEL C. MOLLESTON, M.D., P.A. 401(K) PROFIT SHARING PLAN
|
2009
|
640922102
|
2010-06-25
|
MICHAEL C. MOLLESTON, M.D., P.A.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6014508000
|
Plan sponsor’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394045159
|
Plan administrator’s name and address
Administrator’s EIN |
640922102 |
Plan administrator’s name |
MICHAEL C. MOLLESTON, M.D., P.A. |
Plan administrator’s
address |
P. O. BOX 15159, HATTIESBURG, MS, 394085159 |
Administrator’s telephone number |
6014508000 |
Signature of
Role |
Plan administrator |
Date |
2010-06-25 |
Name of individual signing |
MICHAEL MOLLESTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-06-25 |
Name of individual signing |
MICHAEL MOLLESTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|