|
CLAIMS SERVICE BUREAU OF NEW YORK, INC. EMPLOYEES' PROFIT SHARING PLAN
|
2012
|
112287784
|
2013-06-07
|
CLAIMS SERVICE BUREAU OF NEW YORK, INC.
|
38
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1977-01-01
|
| Business code |
524290
|
| Sponsor’s telephone number |
5165932440
|
| Plan sponsor’s mailing address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
|
| Plan sponsor’s
address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
|
Plan administrator’s name and address
| Administrator’s EIN |
112287784 |
| Plan administrator’s name |
CLAIMS SERVICE BUREAU OF NEW YORK, INC. |
| Plan administrator’s
address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563 |
| Administrator’s telephone number |
5165932440 |
Number of participants as of the end of the plan year
| Active participants |
31 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
4 |
| 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 |
35 |
| 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 |
2013-06-07 |
| Name of individual signing |
DAVID HUTCHINSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-06-07 |
| Name of individual signing |
DAVID HUTCHINSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CLAIMS SERVICE BUREAU OF NEW YORK, INC. EMPLOYEES' PROFIT SHARING PLAN
|
2011
|
112287784
|
2012-05-02
|
CLAIMS SERVICE BUREAU OF NEW YORK, INC.
|
37
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1977-01-01
|
| Business code |
524290
|
| Sponsor’s telephone number |
5165932440
|
| Plan sponsor’s mailing address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
|
| Plan sponsor’s
address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
|
Plan administrator’s name and address
| Administrator’s EIN |
112287784 |
| Plan administrator’s name |
CLAIMS SERVICE BUREAU OF NEW YORK, INC. |
| Plan administrator’s
address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563 |
| Administrator’s telephone number |
5165932440 |
Number of participants as of the end of the plan year
| Active participants |
34 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
4 |
| 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 |
35 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
2 |
Signature of
| Role |
Plan administrator |
| Date |
2012-05-02 |
| Name of individual signing |
DAVID HUTCHINSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CLAIMS SERVICE BUREAU OF NEW YORK, INC. EMPLOYEES' PROFIT SHARING PLAN
|
2010
|
112287784
|
2011-06-08
|
CLAIMS SERVICE BUREAU OF NEW YORK, INC.
|
38
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1977-01-01
|
| Business code |
524290
|
| Sponsor’s telephone number |
5165932440
|
| Plan sponsor’s mailing address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
|
| Plan sponsor’s
address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
|
Plan administrator’s name and address
| Administrator’s EIN |
112287784 |
| Plan administrator’s name |
CLAIMS SERVICE BUREAU OF NEW YORK, INC. |
| Plan administrator’s
address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563 |
| Administrator’s telephone number |
5165932440 |
Number of participants as of the end of the plan year
| Active participants |
31 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
5 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
1 |
| Number of
participants
with
account balances as of the end of the plan year |
37 |
| 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 |
2011-06-08 |
| Name of individual signing |
DAVID HUTCHINSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CLAIMS SERVICE BUREAU OF NEW YORK, INC. EMPLOYEES' PROFIT SHARING PLAN
|
2009
|
112287784
|
2010-06-02
|
CLAIMS SERVICE BUREAU OF NEW YORK, INC.
|
38
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1977-01-01
|
| Business code |
524290
|
| Sponsor’s telephone number |
5165932440
|
| Plan sponsor’s mailing address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
|
| Plan sponsor’s
address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
|
Plan administrator’s name and address
| Administrator’s EIN |
112287784 |
| Plan administrator’s name |
CLAIMS SERVICE BUREAU OF NEW YORK, INC. |
| Plan administrator’s
address |
21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563 |
| Administrator’s telephone number |
5165932440 |
Number of participants as of the end of the plan year
| Active participants |
34 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
3 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
1 |
| Number of
participants
with
account balances as of the end of the plan year |
37 |
| 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 |
2010-06-02 |
| Name of individual signing |
DAVID HUTCHINSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
