PREMIER EYE CARE, PLLC 401(K) PLAN
|
2020
|
611381088
|
2021-01-26
|
PREMIER EYE CARE, PLLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2021-01-26 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2020
|
611381088
|
2021-06-17
|
PREMIER EYE CARE, PLLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2021-06-17 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2019
|
611381088
|
2020-02-14
|
PREMIER EYE CARE, PLLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2020-02-14 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2018
|
611381088
|
2019-04-07
|
PREMIER EYE CARE, PLLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2019-04-07 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2017
|
611381088
|
2018-03-12
|
PREMIER EYE CARE, PLLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2018-03-12 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2016
|
611381088
|
2017-03-03
|
PREMIER EYE CARE, PLLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2017-03-03 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2015
|
611381088
|
2016-03-08
|
PREMIER EYE CARE, PLLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2016-03-08 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2014
|
611381088
|
2015-06-02
|
PREMIER EYE CARE, PLLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2015-06-02 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2013
|
611381088
|
2014-04-07
|
PREMIER EYE CARE, PLLC
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2014-04-07 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2012
|
611381088
|
2013-05-14
|
PREMIER EYE CARE, PLLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8597443937
|
Plan sponsor’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391
|
Signature of
Role |
Plan administrator |
Date |
2013-05-14 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PLLC 401(K) PLAN
|
2011
|
611381088
|
2012-05-29
|
PREMIER EYE CARE, PLLC
|
6
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/05/29/20120529121956P030002070358001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
8597443937 |
Plan sponsor’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391 |
Plan administrator’s name and address
Administrator’s EIN |
611381088 |
Plan administrator’s name |
PREMIER EYE CARE, PLLC |
Plan administrator’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391 |
Administrator’s telephone number |
8597443937 |
Signature of
Role |
Plan administrator |
Date |
2012-05-29 |
Name of individual signing |
MARK W.SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PPLC 401(K) PLAN
|
2010
|
611381088
|
2011-04-01
|
PREMIER EYE CARE, PLLC
|
6
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/01/20110401073727P040162838448001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
8597443937 |
Plan sponsor’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391 |
Plan administrator’s name and address
Administrator’s EIN |
611381088 |
Plan administrator’s name |
PREMIER EYE CARE, PLLC |
Plan administrator’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391 |
Administrator’s telephone number |
8597443937 |
Signature of
Role |
Plan administrator |
Date |
2011-04-01 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER EYE CARE, PPLC 401(K) PLAN
|
2010
|
611381088
|
2011-03-29
|
PREMIER EYE CARE, PLLC
|
6
|
|
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
8597443937 |
Plan sponsor’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391 |
Plan administrator’s name and address
Administrator’s EIN |
611381088 |
Plan administrator’s name |
PREMIER EYE CARE, PLLC |
Plan administrator’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391 |
Administrator’s telephone number |
8597443937 |
Signature of
Role |
Plan administrator |
Date |
2011-03-29 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
PREMIER EYE CARE, PPLC 401(K) PLAN
|
2009
|
611381088
|
2010-07-26
|
PREMIER EYE CARE, PLLC
|
7
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/26/20100726063241P070016966280001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
8597443937 |
Plan sponsor’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391 |
Plan administrator’s name and address
Administrator’s EIN |
611381088 |
Plan administrator’s name |
PREMIER EYE CARE, PLLC |
Plan administrator’s
address |
1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391 |
Administrator’s telephone number |
8597443937 |
Signature of
Role |
Plan administrator |
Date |
2010-07-26 |
Name of individual signing |
MARK W. SIMON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|