|
NORTH SALEM PSYCHIATRIC SERVICES, P.C. PROFIT SHARING PLAN
|
2012
|
133839239
|
2013-07-29
|
NORTH SALEM PSYCHIATRIC SERVICES, P.C.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1995-01-01
|
| Business code |
621112
|
| Sponsor’s telephone number |
9146695526
|
| Plan sponsor’s mailing address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
| Plan sponsor’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
Plan administrator’s name and address
| Administrator’s EIN |
133839239 |
| Plan administrator’s name |
NORTH SALEM PSYCHIATRIC SERVICES, P.C. |
| Plan administrator’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560 |
| Administrator’s telephone number |
9146695526 |
Number of participants as of the end of the plan year
| Active participants |
0 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
0 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2013-07-19 |
| Name of individual signing |
EDWARD GORDON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
NORTH SALEM PSYCHIATRIC SERVICES, P.C. PROFIT SHARING PLAN
|
2011
|
133839239
|
2012-07-13
|
NORTH SALEM PSYCHIATRIC SERVICES, P.C.
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1995-01-01
|
| Business code |
621112
|
| Sponsor’s telephone number |
9146695526
|
| Plan sponsor’s mailing address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
| Plan sponsor’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
Plan administrator’s name and address
| Administrator’s EIN |
133839239 |
| Plan administrator’s name |
NORTH SALEM PSYCHIATRIC SERVICES, P.C. |
| Plan administrator’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560 |
| Administrator’s telephone number |
9146695526 |
Number of participants as of the end of the plan year
| Active participants |
4 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
4 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-16 |
| Name of individual signing |
EDWARD GORDON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
NORTH SALEM PSYCHIATRIC SERVICES, P.C. PROFIT SHARING PLAN
|
2010
|
133839239
|
2011-10-12
|
NORTH SALEM PSYCHIATRIC SERVICES, P.C.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1995-01-01
|
| Business code |
621112
|
| Sponsor’s telephone number |
9146695526
|
| Plan sponsor’s mailing address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
| Plan sponsor’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
Plan administrator’s name and address
| Administrator’s EIN |
133839239 |
| Plan administrator’s name |
NORTH SALEM PSYCHIATRIC SERVICES, P.C. |
| Plan administrator’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560 |
| Administrator’s telephone number |
9146695526 |
Number of participants as of the end of the plan year
| Active participants |
3 |
| Retired or separated participants receiving
benefits |
1 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
4 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-10-11 |
| Name of individual signing |
EDWARD GORDON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
NORTH SALEM PSYCHIATRIC SERVICES, P.C. PROFIT SHARING PLAN
|
2009
|
133839239
|
2011-10-12
|
NORTH SALEM PSYCHIATRIC SERVICES, P.C.
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1995-01-01
|
| Business code |
621112
|
| Sponsor’s telephone number |
9146695526
|
| Plan sponsor’s mailing address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
| Plan sponsor’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
Plan administrator’s name and address
| Administrator’s EIN |
133839239 |
| Plan administrator’s name |
NORTH SALEM PSYCHIATRIC SERVICES, P.C. |
| Plan administrator’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560 |
| Administrator’s telephone number |
9146695526 |
Number of participants as of the end of the plan year
| Active participants |
3 |
| Retired or separated participants receiving
benefits |
1 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
3 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-13 |
| Name of individual signing |
EDWARD GORDON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
NORTH SALEM PSYCHIATRIC SERVICES, P.C. PROFIT SHARING PLAN
|
2009
|
133839239
|
2010-10-13
|
NORTH SALEM PSYCHIATRIC SERVICES, P.C.
|
3
|
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1995-01-01
|
| Business code |
621112
|
| Sponsor’s telephone number |
9146695526
|
| Plan sponsor’s mailing address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
| Plan sponsor’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560
|
Plan administrator’s name and address
| Administrator’s EIN |
133839239 |
| Plan administrator’s name |
NORTH SALEM PSYCHIATRIC SERVICES, P.C. |
| Plan administrator’s
address |
388 HARDSCRABBLE ROAD, NORTH SALEM, NY, 10560 |
| Administrator’s telephone number |
9146695526 |
Number of participants as of the end of the plan year
| Active participants |
3 |
| Retired or separated participants receiving
benefits |
1 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
3 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-13 |
| Name of individual signing |
EDWARD GORDON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
