|
LONG ISLAND SURGICAL SPECIALISTS, P.C. PROFIT SHARING PLAN
|
2012
|
112538736
|
2013-05-18
|
LONG ISLAND SURGICAL SPECIALISTS, P.C.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1998-02-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5164371111
|
| Plan sponsor’s mailing address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042
|
| Plan sponsor’s
address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042
|
Plan administrator’s name and address
| Administrator’s EIN |
112538736 |
| Plan administrator’s name |
LONG ISLAND SURGICAL SPECIALISTS, P.C. |
| Plan administrator’s
address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042 |
| Administrator’s telephone number |
5164371111 |
Number of participants as of the end of the plan year
| Active participants |
0 |
| 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 |
2013-05-18 |
| Name of individual signing |
SANFORD DUBNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LONG ISLAND SURGICAL SPECIALISTS, P.C. PROFIT SHARING PLAN
|
2011
|
112538736
|
2012-10-07
|
LONG ISLAND SURGICAL SPECIALISTS, P.C.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1998-02-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5164371111
|
| Plan sponsor’s mailing address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042
|
| Plan sponsor’s
address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042
|
Plan administrator’s name and address
| Administrator’s EIN |
112538736 |
| Plan administrator’s name |
LONG ISLAND SURGICAL SPECIALISTS, P.C. |
| Plan administrator’s
address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042 |
| Administrator’s telephone number |
5164371111 |
Number of participants as of the end of the plan year
| Active participants |
6 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
2 |
| 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 |
8 |
| 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 |
2012-10-07 |
| Name of individual signing |
SANFORD DUBNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LONG ISLAND SURGICAL SPECIALISTS, P.C. PROFIT SHARING PLAN
|
2010
|
112538736
|
2011-10-02
|
LONG ISLAND SURGICAL SPECIALISTS, P.C.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1998-02-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5164371111
|
| Plan sponsor’s mailing address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042
|
| Plan sponsor’s
address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042
|
Plan administrator’s name and address
| Administrator’s EIN |
112538736 |
| Plan administrator’s name |
LONG ISLAND SURGICAL SPECIALISTS, P.C. |
| Plan administrator’s
address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042 |
| Administrator’s telephone number |
5164371111 |
Number of participants as of the end of the plan year
| Active participants |
7 |
| 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 |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
10 |
| 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 |
2011-10-02 |
| Name of individual signing |
SANFORD DUBNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LONG ISLAND SURGICAL SPECIALISTS, P.C. PROFIT SHARING PLAN
|
2009
|
112230795
|
2010-10-15
|
LONG ISLAND SURGICAL SPECIALISTS, P.C.
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1988-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5168832212
|
| Plan sponsor’s
address |
639 PORT WASHINGTON BLVD, PORT WASHINGTON, NY, 11050
|
Plan administrator’s name and address
| Administrator’s EIN |
112230795 |
| Plan administrator’s name |
LONG ISLAND SURGICAL SPECIALISTS, P.C. |
| Plan administrator’s
address |
639 PORT WASHINGTON BLVD, PORT WASHINGTON, NY, 11050 |
| Administrator’s telephone number |
5168832212 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-15 |
| Name of individual signing |
RENATO B. BERROYA |
|
|
|
LONG ISLAND SURGICAL SPECIALISTS, P.C. PROFIT SHARING PLAN
|
2009
|
112538736
|
2010-08-24
|
LONG ISLAND SURGICAL SPECIALISTS, P.C.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1998-02-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
5164371111
|
| Plan sponsor’s mailing address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042
|
| Plan sponsor’s
address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042
|
Plan administrator’s name and address
| Administrator’s EIN |
112538736 |
| Plan administrator’s name |
LONG ISLAND SURGICAL SPECIALISTS, P.C. |
| Plan administrator’s
address |
410 LAKEVILLE RD STE 310, NEW HYDE PARK, NY, 11042 |
| Administrator’s telephone number |
5164371111 |
Number of participants as of the end of the plan year
| Active participants |
7 |
| 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 |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
10 |
| 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 |
2010-08-24 |
| Name of individual signing |
SANFORD DUBNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
