JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2016
|
113380190
|
2017-10-04
|
JUBIL MALIECKAL, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2017-10-04 |
Name of individual signing |
JUBIL MALIECKAL |
|
|
JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2015
|
113380190
|
2016-10-11
|
JUBIL MALIECKAL, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2016-10-11 |
Name of individual signing |
JUBIL MALIECKAL |
|
|
JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2014
|
113380190
|
2015-08-31
|
JUBIL MALIECKAL, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2015-08-31 |
Name of individual signing |
JUBIL MALIECKAL |
|
|
JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2013
|
113380190
|
2014-09-11
|
JUBIL MALIECKAL, M.D., P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2014-09-11 |
Name of individual signing |
JUBIL MALIECKAL |
|
|
JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2012
|
113380190
|
2013-10-02
|
JUBIL MALIECKAL, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2013-10-02 |
Name of individual signing |
JUBIL MALIECKAL |
|
|
JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2011
|
113380190
|
2012-10-09
|
JUBIL MALIECKAL, M.D., P.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE., BROOKLYN, NY, 11205 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2012-10-09 |
Name of individual signing |
JUBIL MALIECKAL |
|
|
JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2010
|
113380190
|
2011-10-18
|
JUBIL MALIECKAL, M.D., P.C.
|
5
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE, BROOKLYN, NY, 11234
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE, BROOKLYN, NY, 11234 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2011-10-18 |
Name of individual signing |
JUBIL MALIECKAL, MD |
|
Role |
Employer/plan sponsor |
Date |
2011-10-18 |
Name of individual signing |
JUBIL MALIECKAL, MD |
|
|
JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2010
|
113380190
|
2011-11-07
|
JUBIL MALIECKAL, M.D., P.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE, BROOKLYN, NY, 11234
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE, BROOKLYN, NY, 11234 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2011-11-07 |
Name of individual signing |
JUBIL MALIECKAL, MD |
|
Role |
Employer/plan sponsor |
Date |
2011-11-07 |
Name of individual signing |
JUBIL MALIECKAL, MD |
|
|
JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2010
|
113380190
|
2011-10-17
|
JUBIL MALIECKAL, M.D., P.C.
|
5
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE, BROOKLYN, NY, 11234
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE, BROOKLYN, NY, 11234 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2011-10-17 |
Name of individual signing |
JUBIL MALIECKAL, MD |
|
Role |
Employer/plan sponsor |
Date |
2011-10-17 |
Name of individual signing |
JUBIL MALIECKAL, MD |
|
|
JUBIL MALIECKAL, M.D., P.C. PENSION PLAN
|
2009
|
113380190
|
2010-10-15
|
JUBIL MALIECKAL, M.D., P.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1997-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7187897100
|
Plan sponsor’s
address |
242 DEKALB AVE, BROOKLYN, NY, 11234
|
Plan administrator’s name and address
Administrator’s EIN |
113380190 |
Plan administrator’s name |
JUBIL MALIECKAL, M.D., P.C. |
Plan administrator’s
address |
242 DEKALB AVE, BROOKLYN, NY, 11234 |
Administrator’s telephone number |
7187897100 |
Signature of
Role |
Plan administrator |
Date |
2010-10-15 |
Name of individual signing |
JUBIL MALIECKAL, MD |
|
Role |
Employer/plan sponsor |
Date |
2010-10-15 |
Name of individual signing |
JUBIL MALIECKAL, MD |
|
|