BROOKLYN ACADEMY OF MUSIC MEDICAL & DENTAL PLAN
|
2010
|
112201344
|
2011-07-29
|
BROOKLYN ACADEMY OF MUSIC
|
123
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2007-01-01
|
Business code |
711100
|
Sponsor’s telephone number |
7186364105
|
Plan sponsor’s mailing address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan sponsor’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan administrator’s name and address
Administrator’s EIN |
112201344 |
Plan administrator’s name |
BROOKLYN ACADEMY OF MUSIC |
Plan administrator’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217 |
Administrator’s telephone number |
7186364105 |
Number of participants as of the end of the plan year
Active participants |
115 |
Retired or separated participants receiving
benefits |
8 |
Other
retired or separated participants entitled to future benefits |
1 |
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 |
2011-07-29 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-29 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROOKLYN ACADEMY OF MUSIC LIFE AND DISABILITY PLAN
|
2010
|
112201344
|
2011-07-29
|
BROOKLYN ACADEMY OF MUSIC
|
120
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2000-01-01
|
Business code |
711100
|
Sponsor’s telephone number |
7186364105
|
Plan sponsor’s mailing address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan sponsor’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan administrator’s name and address
Administrator’s EIN |
112201344 |
Plan administrator’s name |
BROOKLYN ACADEMY OF MUSIC |
Plan administrator’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217 |
Administrator’s telephone number |
7186364105 |
Number of participants as of the end of the plan year
Active participants |
123 |
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 |
2011-07-29 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-29 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROOKLYN ACADEMY OF MUSIC MEDICAL & DENTAL PLAN
|
2010
|
112201344
|
2011-07-29
|
BROOKLYN ACADEMY OF MUSIC
|
123
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2007-01-01
|
Business code |
711100
|
Sponsor’s telephone number |
7186364105
|
Plan sponsor’s mailing address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan sponsor’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan administrator’s name and address
Administrator’s EIN |
112201344 |
Plan administrator’s name |
BROOKLYN ACADEMY OF MUSIC |
Plan administrator’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217 |
Administrator’s telephone number |
7186364105 |
Number of participants as of the end of the plan year
Active participants |
115 |
Retired or separated participants receiving
benefits |
8 |
Other
retired or separated participants entitled to future benefits |
1 |
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 |
2011-07-29 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-29 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
BROOKLYN ACADEMY OF MUSIC MEDICAL & DENTAL PLAN
|
2009
|
112201344
|
2010-08-12
|
BROOKLYN ACADEMY OF MUSIC
|
109
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2007-01-01
|
Business code |
711100
|
Sponsor’s telephone number |
7186364105
|
Plan sponsor’s mailing address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan sponsor’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan administrator’s name and address
Administrator’s EIN |
112201344 |
Plan administrator’s name |
BROOKLYN ACADEMY OF MUSIC |
Plan administrator’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217 |
Administrator’s telephone number |
7186364105 |
Number of participants as of the end of the plan year
Active participants |
112 |
Retired or separated participants receiving
benefits |
5 |
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 |
2010-08-12 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-08-12 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROOKLYN ACADEMY OF MUSIC LIFE & DISABILITY PLAN
|
2009
|
112201344
|
2010-08-12
|
BROOKLYN ACADEMY OF MUSIC
|
119
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2000-01-01
|
Business code |
711100
|
Sponsor’s telephone number |
7186364105
|
Plan sponsor’s mailing address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan sponsor’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan administrator’s name and address
Administrator’s EIN |
112201344 |
Plan administrator’s name |
BROOKLYN ACADEMY OF MUSIC |
Plan administrator’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217 |
Administrator’s telephone number |
7186364105 |
Number of participants as of the end of the plan year
Active participants |
116 |
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 |
2010-08-12 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-08-12 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROOKLYN ACADEMY OF MUSIC MEDICAL & DENTAL PLAN
|
2009
|
112201344
|
2010-08-12
|
BROOKLYN ACADEMY OF MUSIC
|
115
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2007-01-01
|
Business code |
711100
|
Sponsor’s telephone number |
7186364105
|
Plan sponsor’s mailing address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan sponsor’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan administrator’s name and address
Administrator’s EIN |
112201344 |
Plan administrator’s name |
BROOKLYN ACADEMY OF MUSIC |
Plan administrator’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217 |
Administrator’s telephone number |
7186364105 |
Number of participants as of the end of the plan year
Active participants |
113 |
Retired or separated participants receiving
benefits |
2 |
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 |
2010-08-12 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-08-12 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROOKLYN ACADEMY OF MUSIC MEDICAL & DENTAL PLAN
|
2009
|
112201344
|
2010-08-12
|
BROOKLYN ACADEMY OF MUSIC
|
114
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2007-01-01
|
Business code |
711100
|
Sponsor’s telephone number |
7186364105
|
Plan sponsor’s mailing address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan sponsor’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan administrator’s name and address
Administrator’s EIN |
112201344 |
Plan administrator’s name |
BROOKLYN ACADEMY OF MUSIC |
Plan administrator’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217 |
Administrator’s telephone number |
7186364105 |
Number of participants as of the end of the plan year
Active participants |
114 |
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 |
2010-08-12 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-08-12 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROOKLYN ACADEMY OF MUSIC LIFE & DISABILITY PLAN
|
2009
|
112201344
|
2010-07-30
|
BROOKLYN ACADEMY OF MUSIC
|
119
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2000-01-01
|
Business code |
711100
|
Sponsor’s telephone number |
7186364105
|
Plan sponsor’s mailing address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan sponsor’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217
|
Plan administrator’s name and address
Administrator’s EIN |
112201344 |
Plan administrator’s name |
BROOKLYN ACADEMY OF MUSIC |
Plan administrator’s
address |
30 LAFAYETTE AVE, BROOKLYN, NY, 11217 |
Administrator’s telephone number |
7186364105 |
Number of participants as of the end of the plan year
Active participants |
116 |
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 |
2010-07-30 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-30 |
Name of individual signing |
SETH AZIZOLLAHOFF |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|