CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2019
|
610727156
|
2020-10-12
|
CAPITAL SURGICAL CLINIC P.S.C.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2020-10-12 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2018
|
610727156
|
2019-06-06
|
CAPITAL SURGICAL CLINIC P.S.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2019-06-06 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-06 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2017
|
610727156
|
2018-05-24
|
CAPITAL SURGICAL CLINIC P.S.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2018-05-24 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2016
|
610727156
|
2017-05-11
|
CAPITAL SURGICAL CLINIC P.S.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2017-05-11 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2015
|
610727156
|
2016-04-13
|
CAPITAL SURGICAL CLINIC P.S.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2016-04-13 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-04-13 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2014
|
610727156
|
2015-04-28
|
CAPITAL SURGICAL CLINIC P.S.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2015-04-28 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-04-28 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2013
|
610727156
|
2014-05-14
|
CAPITAL SURGICAL CLINIC P.S.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2014-05-14 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-05-14 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2012
|
610727156
|
2013-04-09
|
CAPITAL SURGICAL CLINIC P.S.C.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Signature of
Role |
Plan administrator |
Date |
2013-04-09 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2011
|
610727156
|
2012-05-10
|
CAPITAL SURGICAL CLINIC P.S.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Plan administrator’s name and address
Administrator’s EIN |
610727156 |
Plan administrator’s name |
CAPITAL SURGICAL CLINIC P.S.C. |
Plan administrator’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5022237629 |
Signature of
Role |
Plan administrator |
Date |
2012-05-10 |
Name of individual signing |
STEVEN VALLANCE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2010
|
610727156
|
2011-07-06
|
CAPITAL SURGICAL CLINIC P.S.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1999-08-11
|
Business code |
621111
|
Sponsor’s telephone number |
5022237629
|
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601
|
Plan administrator’s name and address
Administrator’s EIN |
610727156 |
Plan administrator’s name |
CAPITAL SURGICAL CLINIC P.S.C. |
Plan administrator’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5022237629 |
Signature of
Role |
Plan administrator |
Date |
2011-07-06 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPITAL SURGICAL CLINIC P.S.C. 401(K) PLAN
|
2009
|
610727156
|
2010-07-22
|
CAPITAL SURGICAL CLINIC P.S.C.
|
13
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/22/20100722134321P040126259346001.pdf |
Three-digit plan number (PN) |
002 |
Effective date of plan |
1999-08-11 |
Business code |
621111 |
Sponsor’s telephone number |
5022237629 |
Plan sponsor’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601 |
Plan administrator’s name and address
Administrator’s EIN |
610727156 |
Plan administrator’s name |
CAPITAL SURGICAL CLINIC P.S.C. |
Plan administrator’s
address |
ONE PHYSICIANS PARK, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5022237629 |
Signature of
Role |
Plan administrator |
Date |
2010-07-22 |
Name of individual signing |
CRYSTAL THURMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|