|
401K EMPLOYEE RETIREMENT PLAN
|
2023
|
721544372
|
2024-07-16
|
MADISON VISION CENTER, PLLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
621330
|
| Sponsor’s telephone number |
6625363680
|
| Plan sponsor’s
address |
6823 ELMORE ROAD, SOUTHAVEN, MS, 38671
|
Plan administrator’s name and address
| Administrator’s EIN |
452557054 |
| Plan administrator’s name |
RETIREMENT PLAN SERVICES, LLC |
| Plan administrator’s
address |
4209 LAKELAND DRIVE, FLOWOOD, MS, 39232 |
| Administrator’s telephone number |
6019191023 |
Signature of
| Role |
Plan administrator |
| Date |
2024-07-16 |
| Name of individual signing |
SCOTT HILL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
401K EMPLOYEE RETIREMENT PLAN
|
2022
|
721544372
|
2023-07-14
|
MADISON VISION CENTER, PLLC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
621330
|
| Sponsor’s telephone number |
6625363680
|
| Plan sponsor’s
address |
6823 ELMORE ROAD, SOUTHAVEN, MS, 38671
|
Plan administrator’s name and address
| Administrator’s EIN |
452557054 |
| Plan administrator’s name |
RETIREMENT PLAN SERVICES, LLC |
| Plan administrator’s
address |
4209 LAKELAND DRIVE, FLOWOOD, MS, 39232 |
| Administrator’s telephone number |
6019191023 |
Signature of
| Role |
Plan administrator |
| Date |
2023-07-14 |
| Name of individual signing |
SCOTT HILL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
401K EMPLOYEE RETIREMENT PLAN
|
2021
|
721544372
|
2022-07-25
|
MADISON VISION CENTER, PLLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
621330
|
| Sponsor’s telephone number |
6625363680
|
| Plan sponsor’s
address |
6823 ELMORE ROAD, SOUTHAVEN, MS, 38671
|
Plan administrator’s name and address
| Administrator’s EIN |
452557054 |
| Plan administrator’s name |
RETIREMENT PLAN SERVICES, LLC |
| Plan administrator’s
address |
4209 LAKELAND DRIVE, FLOWOOD, MS, 39232 |
| Administrator’s telephone number |
6019191023 |
Signature of
| Role |
Plan administrator |
| Date |
2022-07-25 |
| Name of individual signing |
SCOTT HILL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
401K EMPLOYEE RETIREMENT PLAN
|
2020
|
721544372
|
2021-07-28
|
MADISON VISION CENTER, PLLC
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
621330
|
| Sponsor’s telephone number |
6625363680
|
| Plan sponsor’s
address |
6823 ELMORE ROAD, SOUTHAVEN, MS, 38671
|
Plan administrator’s name and address
| Administrator’s EIN |
452557054 |
| Plan administrator’s name |
RETIREMENT PLAN SERVICES, LLC |
| Plan administrator’s
address |
4209 LAKELAND DRIVE, FLOWOOD, MS, 39232 |
| Administrator’s telephone number |
6019191023 |
Signature of
| Role |
Plan administrator |
| Date |
2021-07-28 |
| Name of individual signing |
SCOTT HILL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
