|
JAMES H. MARTIN JR., M.D., P.S.C 401(K) PLAN
|
2016
|
611365255
|
2017-07-31
|
JAMES H. MARTIN JR., M.D., P.S.C
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6068363770
|
| Plan sponsor’s
address |
900 ST. CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
Signature of
| Role |
Plan administrator |
| Date |
2017-07-31 |
| Name of individual signing |
JAMES H. MARTIN, JR. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JAMES H. MARTIN JR., M.D., P.S.C 401(K) PLAN
|
2015
|
611365255
|
2016-08-25
|
JAMES H. MARTIN JR., M.D., P.S.C
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6068363770
|
| Plan sponsor’s
address |
900 ST. CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
Signature of
| Role |
Plan administrator |
| Date |
2016-08-25 |
| Name of individual signing |
RAYDIA MARTIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JAMES H. MARTIN JR., M.D., P.S.C 401(K) PLAN
|
2014
|
611365255
|
2016-08-25
|
JAMES H. MARTIN JR., M.D., P.S.C
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6068363770
|
| Plan sponsor’s
address |
900 ST. CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
Signature of
| Role |
Plan administrator |
| Date |
2016-08-25 |
| Name of individual signing |
RAYDIA MARTIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JAMES H. MARTIN JR., M.D., P.S.C 401(K) PLAN
|
2013
|
611365255
|
2016-08-25
|
JAMES H. MARTIN JR., M.D., P.S.C
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6068363770
|
| Plan sponsor’s
address |
900 ST. CHRISTOPHER DRIVE, SUITE 202, ASHLAND, KY, 41101
|
Signature of
| Role |
Plan administrator |
| Date |
2016-08-25 |
| Name of individual signing |
RAYDIA MARTIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JAMES H. MARTIN JR., M.D., P.S.C 401(K) PLAN
|
2010
|
611365255
|
2011-08-17
|
JAMES H. MARTIN JR., M.D., P.S.C
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6068363770
|
| Plan sponsor’s mailing address |
900 ST. CHRISTOPHER DRIVE, ASHLAND, KY, 41101
|
| Plan sponsor’s
address |
SUITE 202, ASHLAND, KY, 41101
|
Plan administrator’s name and address
| Administrator’s EIN |
611365255 |
| Plan administrator’s name |
JAMES H. MARTIN JR., M.D., P.S.C |
| Plan administrator’s
address |
900 ST. CHRISTOPHER DRIVE, ASHLAND, KY, 41101 |
| Administrator’s telephone number |
6068363770 |
Number of participants as of the end of the plan year
| Active participants |
4 |
| 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 |
4 |
| 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 |
2011-08-17 |
| Name of individual signing |
JAMES H. MARTIN, JR. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JAMES H. MARTIN JR., M.D., P.S.C 401(K) PLAN
|
2009
|
611365255
|
2010-10-14
|
JAMES H. MARTIN JR., M.D., P.S.C
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2002-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6068363770
|
| Plan sponsor’s mailing address |
900 ST. CHRISTOPHER DRIVE, ASHLAND, KY, 41101
|
| Plan sponsor’s
address |
SUITE 202, ASHLAND, KY, 41101
|
Plan administrator’s name and address
| Administrator’s EIN |
611365255 |
| Plan administrator’s name |
JAMES H. MARTIN JR., M.D., P.S.C |
| Plan administrator’s
address |
900 ST. CHRISTOPHER DRIVE, ASHLAND, KY, 41101 |
| Administrator’s telephone number |
6068363770 |
Number of participants as of the end of the plan year
| Active participants |
5 |
| 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 |
4 |
| 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 |
2010-10-14 |
| Name of individual signing |
JAMES H. MARTIN, JR. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
