GBC LIFE INSURANCE AND ADD INSURANCE PROGRAM
|
2015
|
133458782
|
2016-09-29
|
GRANITE BROADCASTING CORPORATION
|
327
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1991-05-01
|
Business code |
515100
|
Sponsor’s telephone number |
2128262530
|
Plan sponsor’s mailing address |
750 3RD AVE FL 9, NEW YORK, NY, 100172718
|
Plan sponsor’s
address |
750 3RD AVE FL 9, NEW YORK, NY, 100172718
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-09-29 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-09-29 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GBC LONG TERM DISABILITY
|
2015
|
133458782
|
2016-09-29
|
GRANITE BROADCASTING CORPORATION
|
327
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1991-05-01
|
Business code |
515100
|
Sponsor’s telephone number |
2124562530
|
Plan sponsor’s mailing address |
750 3RD AVE FL 9, NEW YORK, NY, 100172718
|
Plan sponsor’s
address |
750 3RD AVE FL 9, NEW YORK, NY, 100172718
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-09-29 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-09-29 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GBC HEALTH CARE PLAN
|
2015
|
133458782
|
2016-09-29
|
GRANITE BROADCASTING CORPORATION
|
327
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1991-05-01
|
Business code |
515100
|
Sponsor’s telephone number |
2128262530
|
Plan sponsor’s mailing address |
750 3RD AVE FL 9, NEW YORK, NY, 100172718
|
Plan sponsor’s
address |
750 3RD AVE FL 9, NEW YORK, NY, 100172718
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-09-29 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-09-29 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GBC LIFE INSURANCE AND ADD INSURANCE PROGRAM
|
2014
|
133458782
|
2015-10-07
|
GRANITE BROADCASTING CORPORATION
|
453
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1991-05-01
|
Business code |
515100
|
Sponsor’s telephone number |
2128262530
|
Plan sponsor’s mailing address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Plan sponsor’s
address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GBC PRE TAX PREMIUM AND HEALTHCARE REIMBURSEMENT ACCOUNT
|
2014
|
133458782
|
2015-10-07
|
GRANITE BROADCASTING CORPORATION
|
453
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1991-05-01
|
Business code |
515100
|
Sponsor’s telephone number |
2128262530
|
Plan sponsor’s mailing address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Plan sponsor’s
address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GBC SHORT TERM DISABILITY
|
2014
|
133458782
|
2015-10-07
|
GRANITE BROADCASTING CORPORATION
|
453
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
1991-05-01
|
Business code |
515100
|
Sponsor’s telephone number |
2128262530
|
Plan sponsor’s mailing address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Plan sponsor’s
address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GBC EMPLOYEE ASSISTANCE PLAN
|
2014
|
133458782
|
2015-10-07
|
GRANITE BROADCASTING CORPORATION
|
453
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
2006-01-01
|
Business code |
515100
|
Sponsor’s telephone number |
2128262530
|
Plan sponsor’s mailing address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Plan sponsor’s
address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GBC HEALTH CARE PLAN
|
2014
|
133458782
|
2015-10-07
|
GRANITE BROADCASTING CORPORATION
|
453
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1991-05-01
|
Business code |
515100
|
Sponsor’s telephone number |
2128262530
|
Plan sponsor’s mailing address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Plan sponsor’s
address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GBC LONG TERM DISABILITY
|
2014
|
133458782
|
2015-10-07
|
GRANITE BROADCASTING CORPORATION
|
453
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1991-05-01
|
Business code |
515100
|
Sponsor’s telephone number |
2128462530
|
Plan sponsor’s mailing address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Plan sponsor’s
address |
767 THIRD AVENUE, NEW YORK, NY, 10017
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-07 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GBC HEALTH CARE PLAN
|
2013
|
133458782
|
2014-10-08
|
GRANITE BROADCASTING CORPORATION
|
524
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1991-05-01
|
Business code |
515100
|
Sponsor’s telephone number |
2128262530
|
Plan sponsor’s mailing address |
767 THIRD AVENUE, 34TH FLOOR, NEW YORK, NY, 10017
|
Plan sponsor’s
address |
767 THIRD AVENUE, 34TH FLOOR, NEW YORK, NY, 10017
|
Plan administrator’s name and address
Administrator’s EIN |
133458782 |
Plan administrator’s name |
GRANITE BROADCASTING CORPORATION |
Plan administrator’s
address |
767 THIRD AVENUE, 34TH FLOOR, NEW YORK, NY, 10017 |
Administrator’s telephone number |
2128262530 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-10-08 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-10-08 |
Name of individual signing |
LAWRENCE WILLS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|