|
ROBERT L. JACOBSON PROFIT SHARING PLAN
|
2011
|
161375635
|
2012-10-15
|
ROBERT L. JACOBSON
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2003-01-01
|
| Business code |
541110
|
| Sponsor’s telephone number |
5852186290
|
| Plan sponsor’s mailing address |
1080 PITTSFORD VICTOR RD., SUITE # 304, PITTSFORD, NY, 14534
|
| Plan sponsor’s
address |
1080 PITTSFORD VICTOR RD., SUITE # 304, PITTSFORD, NY, 14534
|
Plan administrator’s name and address
| Administrator’s EIN |
161375635 |
| Plan administrator’s name |
ROBERT L. JACOBSON |
| Plan administrator’s
address |
1080 PITTSFORD VICTOR RD., SUITE # 304, PITTSFORD, NY, 14534 |
| Administrator’s telephone number |
5852186290 |
Number of participants as of the end of the plan year
| Active participants |
2 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
| Role |
Plan administrator |
| Date |
2012-10-15 |
| Name of individual signing |
ROBERT JACOBSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ROBERT L. JACOBSON 401K PROFIT SHARING PLAN
|
2010
|
161375635
|
2011-10-12
|
ROBERT L. JACOBSON
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2003-01-01
|
| Business code |
541110
|
| Sponsor’s telephone number |
5852186290
|
| Plan sponsor’s mailing address |
1080 PITTSFORD VICTOR RD., SUITE # 304, PITTSFORD, NY, 14534
|
| Plan sponsor’s
address |
1080 PITTSFORD VICTOR RD., SUITE # 304, PITTSFORD, NY, 14534
|
Plan administrator’s name and address
| Administrator’s EIN |
161375635 |
| Plan administrator’s name |
ROBERT L. JACOBSON |
| Plan administrator’s
address |
1080 PITTSFORD VICTOR RD., SUITE # 304, PITTSFORD, NY, 14534 |
| Administrator’s telephone number |
5852186290 |
Number of participants as of the end of the plan year
| Active participants |
3 |
| 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 |
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 |
2011-10-12 |
| Name of individual signing |
ROBERT JACOBSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-10-12 |
| Name of individual signing |
ROBERT JACOBSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ROBERT L. JACOBSON 401K PROFIT SHARING PLAN
|
2009
|
161375635
|
2010-10-13
|
ROBERT L. JACOBSON
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2003-01-01
|
| Business code |
541110
|
| Sponsor’s telephone number |
5852186290
|
| Plan sponsor’s mailing address |
1080 PITTSFORD VICTOR RD., SUITE #304, PITTSFORD, NY, 14534
|
| Plan sponsor’s
address |
1080 PITTSFORD VICTOR RD., SUITE #304, PITTSFORD, NY, 14534
|
Plan administrator’s name and address
| Administrator’s EIN |
161375635 |
| Plan administrator’s name |
ROBERT L. JACOBSON |
| Plan administrator’s
address |
1080 PITTSFORD VICTOR RD., SUITE #304, PITTSFORD, NY, 14534 |
| Administrator’s telephone number |
5852186290 |
Number of participants as of the end of the plan year
| Active participants |
2 |
| 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 |
2 |
| 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 |
2010-10-12 |
| Name of individual signing |
ROBERT JACOBSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ROBERT L. JACOBSON 401K PROFIT SHARING PLAN
|
2009
|
161375635
|
2010-10-12
|
ROBERT L. JACOBSON
|
2
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2003-01-01
|
| Business code |
541110
|
| Sponsor’s telephone number |
5852186290
|
| Plan sponsor’s mailing address |
1080 PITTSFORD VICTOR RD., SUITE #304, PITTSFORD, NY, 14534
|
| Plan sponsor’s
address |
1080 PITTSFORD VICTOR RD., SUITE #304, PITTSFORD, NY, 14534
|
Plan administrator’s name and address
| Administrator’s EIN |
161375635 |
| Plan administrator’s name |
ROBERT L. JACOBSON |
| Plan administrator’s
address |
1080 PITTSFORD VICTOR RD., SUITE #304, PITTSFORD, NY, 14534 |
| Administrator’s telephone number |
5852186290 |
Number of participants as of the end of the plan year
| Active participants |
2 |
| 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 |
2 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
|
