PAIN CARE, PSC 401(K) PROFIT SHARING PLAN
|
2016
|
810551449
|
2017-02-17
|
PAIN CARE, PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-05-14
|
Business code |
621111
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105
|
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2017-02-17 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC 401(K) PROFIT SHARING PLAN
|
2015
|
810551449
|
2016-09-30
|
PAIN CARE, PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-05-14
|
Business code |
621111
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105
|
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2016-09-30 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC 401(K) PROFIT SHARING PLAN
|
2014
|
810551449
|
2015-10-12
|
PAIN CARE, PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-05-14
|
Business code |
621111
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105
|
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2015-10-12 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC DEFINED BENEFIT PENSION PLAN
|
2014
|
810551449
|
2015-10-12
|
PAIN CARE, PSC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2005-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
2201 LEXINGTON AVENUE, ASHLAND, KY, 411012873
|
Signature of
Role |
Plan administrator |
Date |
2015-10-12 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC DEFINED BENEFIT PENSION PLAN
|
2014
|
810551449
|
2015-10-13
|
PAIN CARE, PSC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2005-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
2301 LEXINGTON AVENUE, ASHLAND, KY, 411012873
|
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC 401(K) PROFIT SHARING PLAN
|
2013
|
810551449
|
2014-10-13
|
PAIN CARE, PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-05-14
|
Business code |
621111
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105
|
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2014-10-13 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC DEFINED BENEFIT PENSION PLAN
|
2013
|
810551449
|
2014-07-29
|
PAIN CARE, PSC
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2005-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
2201 LEXINGTON AVENUE, ASHLAND, KY, 411012873
|
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
2201 LEXINGTON AVENUE, ASHLAND, KY, 411012873 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2014-07-29 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC DEFINED BENEFIT PENSION PLAN
|
2012
|
810551449
|
2013-09-16
|
PAIN CARE, PSC
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2005-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
2201 LEXINGTON AVENUE, ASHLAND, KY, 411012873
|
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
2201 LEXINGTON AVENUE, ASHLAND, KY, 411012873 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2013-09-16 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC 401(K) PROFIT SHARING PLAN
|
2012
|
810551449
|
2013-09-16
|
PAIN CARE, PSC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2002-05-14
|
Business code |
621111
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105
|
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2013-09-16 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC DEFINED BENEFIT PENSION PLAN
|
2011
|
810551449
|
2012-10-12
|
PAIN CARE, PSC
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2005-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
6063277228
|
Plan sponsor’s
address |
2201 LEXINGTON AVENUE, ASHLAND, KY, 411012873
|
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
2201 LEXINGTON AVENUE, ASHLAND, KY, 411012873 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2012-10-12 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC 401(K) PROFIT SHARING PLAN
|
2011
|
810551449
|
2012-10-12
|
PAIN CARE, PSC
|
4
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/12/20121012034109P040001354486001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2002-05-14 |
Business code |
621111 |
Sponsor’s telephone number |
6063277228 |
Plan sponsor’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2012-10-12 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC DEFINED BENEFIT PENSION PLAN
|
2010
|
810551449
|
2011-10-12
|
PAIN CARE, PSC
|
3
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/12/20111012172337P030021761954001.pdf |
Three-digit plan number (PN) |
002 |
Effective date of plan |
2005-01-01 |
Business code |
621399 |
Sponsor’s telephone number |
6063277228 |
Plan sponsor’s
address |
2201 LEXINGTON AVENUE, ASHLAND, KY, 411012873 |
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
2201 LEXINGTON AVENUE, ASHLAND, KY, 411012873 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2011-10-12 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC 401(K) PROFIT SHARING PLAN
|
2010
|
810551449
|
2011-10-12
|
PAIN CARE, PSC
|
3
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/12/20111012172132P030147622881001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2002-05-14 |
Business code |
621111 |
Sponsor’s telephone number |
6063277228 |
Plan sponsor’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2011-10-12 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC DEFINED BENEFIT PENSION PLAN
|
2009
|
810551449
|
2010-10-12
|
PAIN CARE, PSC
|
2
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/12/20101012183101P030023233585001.pdf |
Three-digit plan number (PN) |
002 |
Effective date of plan |
2005-01-01 |
Business code |
621399 |
Sponsor’s telephone number |
6063277228 |
Plan sponsor’s
address |
2301 LEXINGTON AVENUE, ASHLAND, KY, 41105 |
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
2301 LEXINGTON AVENUE, ASHLAND, KY, 41105 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2010-10-12 |
Name of individual signing |
LEON BRIGGS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-12 |
Name of individual signing |
LEON BRIGGS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PAIN CARE, PSC 401(K) PROFIT SHARING PLAN
|
2009
|
810551449
|
2010-10-08
|
PAIN CARE, PSC
|
3
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/08/20101008094616P030000986165001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2002-05-14 |
Business code |
621111 |
Sponsor’s telephone number |
6063277228 |
Plan sponsor’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Plan administrator’s name and address
Administrator’s EIN |
810551449 |
Plan administrator’s name |
PAIN CARE, PSC |
Plan administrator’s
address |
P.O. BOX 1109, ASHLAND, KY, 41105 |
Administrator’s telephone number |
6063277228 |
Signature of
Role |
Plan administrator |
Date |
2010-10-08 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-08 |
Name of individual signing |
LEON BRIGGS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|