PENNYRILE UROLOGY, P.S.C. PENNYRILE UROLOGY, P.S.C. (T)
|
2014
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610716722
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2015-12-17
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PENNYRILE UROLOGY, P.S.C.
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10
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|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911
|
Signature of
Role |
Plan administrator |
Date |
2015-12-17 |
Name of individual signing |
H. KENDRICK DOUGHERTY, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
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PENNYRILE UROLOGY, P.S.C. PROFIT SHARING PLAN
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2014
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610716722
|
2015-02-23
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PENNYRILE UROLOGY, P.S.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911
|
Plan administrator’s name and address
Administrator’s EIN |
610716722 |
Plan administrator’s name |
PENNYRILE UROLOGY, P.S.C. |
Plan administrator’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911 |
Administrator’s telephone number |
5028865141 |
Signature of
Role |
Plan administrator |
Date |
2015-02-23 |
Name of individual signing |
H. KENDRICK DOUGHERTY, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PENNYRILE UROLOGY, P.S.C. PROFIT SHARING PLAN
|
2013
|
610716722
|
2014-02-04
|
PENNYRILE UROLOGY, P.S.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911
|
Plan administrator’s name and address
Administrator’s EIN |
610716722 |
Plan administrator’s name |
PENNYRILE UROLOGY, P.S.C. |
Plan administrator’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911 |
Administrator’s telephone number |
5028865141 |
Signature of
Role |
Plan administrator |
Date |
2014-02-04 |
Name of individual signing |
H. KENDRICK DOUGHERTY, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PENNYRILE UROLOGY, P.S.C. PROFIT SHARING PLAN
|
2012
|
610716722
|
2013-02-04
|
PENNYRILE UROLOGY, P.S.C.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911
|
Plan administrator’s name and address
Administrator’s EIN |
610716722 |
Plan administrator’s name |
PENNYRILE UROLOGY, P.S.C. |
Plan administrator’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911 |
Administrator’s telephone number |
5028865141 |
Signature of
Role |
Plan administrator |
Date |
2013-02-04 |
Name of individual signing |
H. KENDRICK DOUGHERTY, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PENNYRILE UROLOGY, P.S.C. PROFIT SHARING PLAN
|
2011
|
610716722
|
2012-01-30
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PENNYRILE UROLOGY, P.S.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911
|
Plan administrator’s name and address
Administrator’s EIN |
610716722 |
Plan administrator’s name |
PENNYRILE UROLOGY, P.S.C. |
Plan administrator’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911 |
Administrator’s telephone number |
5028865141 |
Signature of
Role |
Plan administrator |
Date |
2012-01-30 |
Name of individual signing |
H. KENDRICK DOUGHERTY, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PENNYRILE UROLOGY, P.S.C. PROFIT SHARING PLAN
|
2011
|
610716722
|
2012-01-30
|
PENNYRILE UROLOGY, P.S.C.
|
12
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911
|
Plan administrator’s name and address
Administrator’s EIN |
610716722 |
Plan administrator’s name |
PENNYRILE UROLOGY, P.S.C. |
Plan administrator’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911 |
Administrator’s telephone number |
5028865141 |
Signature of
Role |
Plan administrator |
Date |
2012-01-30 |
Name of individual signing |
H. KENDRICK DOUGHTERY, M.D. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
PENNYRILE UROLOGY, P.S.C. PROFIT SHARING PLAN
|
2011
|
610716722
|
2012-01-30
|
PENNYRILE UROLOGY, P.S.C.
|
12
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911
|
Plan administrator’s name and address
Administrator’s EIN |
610716722 |
Plan administrator’s name |
PENNYRILE UROLOGY, P.S.C. |
Plan administrator’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911 |
Administrator’s telephone number |
5028865141 |
Signature of
Role |
Plan administrator |
Date |
2012-01-30 |
Name of individual signing |
H. KENDRICK DOUGHERTY, M.D. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
PENNYRILE UROLOGY, P.S.C. PROFIT SHARING PLAN
|
2011
|
610716722
|
2012-01-30
|
PENNYRILE UROLOGY, P.S.C.
|
12
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911
|
Plan administrator’s name and address
Administrator’s EIN |
610716722 |
Plan administrator’s name |
PENNYRILE UROLOGY, P.S.C. |
Plan administrator’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911 |
Administrator’s telephone number |
5028865141 |
Signature of
Role |
Plan administrator |
Date |
2012-01-30 |
Name of individual signing |
H. KENDRICK DOUGHERTY, M.D. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
PENNYRILE UROLOGY, P.S.C. PROFIT SHARING PLAN
|
2010
|
610716722
|
2011-03-09
|
PENNYRILE UROLOGY, P.S.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911
|
Plan administrator’s name and address
Administrator’s EIN |
610716722 |
Plan administrator’s name |
PENNYRILE UROLOGY, P.S.C. |
Plan administrator’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 422401911 |
Administrator’s telephone number |
5028865141 |
Signature of
Role |
Plan administrator |
Date |
2011-03-09 |
Name of individual signing |
H. KENDRICK DOUGHTERY, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PENNYRILE UROLOGY, P.S.C. PROFIT SHARING PLAN
|
2009
|
610716722
|
2010-08-04
|
PENNYRILE UROLOGY, P.S.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5028865141
|
Plan sponsor’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 42240
|
Plan administrator’s name and address
Administrator’s EIN |
610716722 |
Plan administrator’s name |
PENNYRILE UROLOGY, P.S.C. |
Plan administrator’s
address |
219 W. 17TH STREET, HOPKINSVILLE, KY, 42240 |
Administrator’s telephone number |
5028865141 |
Signature of
Role |
Plan administrator |
Date |
2010-08-04 |
Name of individual signing |
H KENDRICK DOUGHERTY, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-08-04 |
Name of individual signing |
H KENDRICK DOUGHERTY, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|