MIDSOUTH MEDICINE 401(K) PROFIT
|
2016
|
201213308
|
2017-02-13
|
MIDSOUTH MEDICINE
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6623421112
|
Plan sponsor’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671
|
Signature of
Role |
Plan administrator |
Date |
2017-02-13 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-02-13 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIDSOUTH MEDICINE 401(K) PROFIT SHARING PLAN & TRUST
|
2015
|
201213308
|
2017-01-12
|
MIDSOUTH MEDICINE
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6623421112
|
Plan sponsor’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671
|
Signature of
Role |
Plan administrator |
Date |
2017-01-12 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-01-12 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIDSOUTH MEDICINE 401(K) PROFIT SHARING PLAN & TRUST
|
2015
|
201213308
|
2016-06-01
|
MIDSOUTH MEDICINE
|
18
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6623421112
|
Plan sponsor’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671
|
Signature of
Role |
Plan administrator |
Date |
2016-06-01 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIDSOUTH MEDICINE 401(K) PROFIT SHARING PLAN & TRUST
|
2014
|
201213308
|
2015-06-09
|
MIDSOUTH MEDICINE
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6623421112
|
Plan sponsor’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671
|
Signature of
Role |
Plan administrator |
Date |
2015-06-09 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIDSOUTH MEDICINE 401(K) PROFIT SHARING PLAN & TRUST
|
2013
|
201213308
|
2014-06-03
|
MIDSOUTH MEDICINE
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6623421112
|
Plan sponsor’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671
|
Signature of
Role |
Plan administrator |
Date |
2014-06-03 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIDSOUTH MEDICINE 401(K) PROFIT SHARING PLAN & TRUST
|
2012
|
201213308
|
2013-08-20
|
MIDSOUTH MEDICINE
|
7
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6623421112
|
Plan sponsor’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671
|
Signature of
Role |
Plan administrator |
Date |
2013-08-20 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIDSOUTH MEDICINE 401(K) PROFIT SHARING PLAN & TRUST
|
2012
|
201213308
|
2013-09-12
|
MIDSOUTH MEDICINE
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6623421112
|
Plan sponsor’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671
|
Signature of
Role |
Plan administrator |
Date |
2013-09-12 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIDSOUTH MEDICINE 401(K) PROFIT SHARING PLAN & TRUST
|
2011
|
201213308
|
2012-06-12
|
MIDSOUTH MEDICINE
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6623421112
|
Plan sponsor’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671
|
Plan administrator’s name and address
Administrator’s EIN |
201213308 |
Plan administrator’s name |
MIDSOUTH MEDICINE |
Plan administrator’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671 |
Administrator’s telephone number |
6623421112 |
Signature of
Role |
Plan administrator |
Date |
2012-06-12 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIDSOUTH MEDICINE 401(K) PROFIT SHARING PLAN & TRUST
|
2010
|
201213308
|
2011-07-18
|
MIDSOUTH MEDICINE
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6623421112
|
Plan sponsor’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671
|
Plan administrator’s name and address
Administrator’s EIN |
201213308 |
Plan administrator’s name |
MIDSOUTH MEDICINE |
Plan administrator’s
address |
2149 W STATELINE ROAD, SOUTHAVEN, MS, 38671 |
Administrator’s telephone number |
6623421112 |
Signature of
Role |
Plan administrator |
Date |
2011-07-18 |
Name of individual signing |
CIAO NEWMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MIDSOUTH MEDICINE 401 K PROFIT SHARING PLAN & TRUST
|
2009
|
201213308
|
2012-01-25
|
MIDSOUTH MEDICINE
|
No data
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Plan sponsor’s mailing address |
2149 STATELINE RD W, SOUTHHAVEN, MS, 38671
|
Plan sponsor’s
address |
2149 STATELINE RD W, SOUTHHAVEN, MS, 38671
|
Plan administrator’s name and address
Administrator’s EIN |
201213308 |
Plan administrator’s name |
MIDSOUTH MEDICINE |
Plan administrator’s
address |
2149 STATELINE RD W, SOUTHHAVEN, MS, 38671 |
|
MIDSOUTH MEDICINE
|
2009
|
201213308
|
2010-07-19
|
MIDSOUTH MEDICINE
|
6
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/19/20100719150121P030130310674001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2005-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
6623421112 |
Plan sponsor’s
address |
2149 STATELINE RD W, SOUTHAVEN, MS, 386710000 |
Plan administrator’s name and address
Administrator’s EIN |
201213308 |
Plan administrator’s name |
MIDSOUTH MEDICINE |
Plan administrator’s
address |
2149 STATELINE RD W, SOUTHAVEN, MS, 386710000 |
Administrator’s telephone number |
6623421112 |
Signature of
Role |
Plan administrator |
Date |
2010-07-19 |
Name of individual signing |
MIDSOUTH MEDICINE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|