|
CLARK CHIROPRACTIC CENTER, LLC 401(K) RETIREMENT PLAN
|
2015
|
200759138
|
2018-06-20
|
CLARK CHIROPRACTIC CENTER LLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2005-01-01
|
| Business code |
621310
|
| Sponsor’s telephone number |
2708529355
|
| Plan
sponsor’s DBA name |
OWENSBORO CHIROPRACTIC & FAMILY PRACTICE
|
| Plan sponsor’s mailing address |
507 E PARRISH AVE, OWENSBORO, KY, 423033126
|
| Plan sponsor’s
address |
507 E PARRISH AVE, OWENSBORO, KY, 423033126
|
Number of participants as of the end of the plan year
| Active participants |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2018-06-20 |
| Name of individual signing |
AARON CLARK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2018-06-20 |
| Name of individual signing |
AARON CLARK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CLARK CHIROPRACTIC CENTER, LLC 401(K) RETIREMENT PLAN
|
2014
|
200759138
|
2015-07-27
|
CLARK CHIROPRACTIC CENTER, LLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2005-01-01
|
| Business code |
621310
|
| Sponsor’s telephone number |
2708529355
|
| Plan
sponsor’s DBA name |
OWENSBORO CHIROPRACTIC & FAMILY PR
|
| Plan sponsor’s mailing address |
507 EAST PARRISH AVENUE, OWENSBORO, KY, 42303
|
| Plan sponsor’s
address |
507 EAST PARRISH AVENUE, OWENSBORO, KY, 42303
|
Plan administrator’s name and address
| Administrator’s EIN |
200759138 |
| Plan administrator’s name |
CLARK CHIROPRACTIC CENTER, LLC |
| Plan administrator’s
address |
P.O. BOX 1394, OWENSBORO, KY, 42302 |
| Administrator’s telephone number |
2708529355 |
Number of participants as of the end of the plan year
| Active participants |
3 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
1 |
| 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 |
2015-06-16 |
| Name of individual signing |
AARON P. CLARK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2015-06-16 |
| Name of individual signing |
AARON P. CLARK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CLARK CHIROPRACTIC CENTER, LLC 401(K) RETIREMENT PLAN
|
2013
|
200759138
|
2014-07-30
|
CLARK CHIROPRACTIC CENTER, LLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2005-01-01
|
| Business code |
621310
|
| Sponsor’s telephone number |
2708529355
|
| Plan
sponsor’s DBA name |
OWENSBORO CHIROPRACTIC & FAMILY PR
|
| Plan sponsor’s mailing address |
P.O. BOX 1394, OWENSBORO, KY, 423021394
|
| Plan sponsor’s
address |
507 EAST PARRISH AVENUE, OWENSBORO, KY, 42303
|
Plan administrator’s name and address
| Administrator’s EIN |
200759138 |
| Plan administrator’s name |
CLARK CHIROPRACTIC CENTER, LLC |
| Plan administrator’s
address |
P.O. BOX 1394, OWENSBORO, KY, 42302 |
| Administrator’s telephone number |
2708529355 |
Number of participants as of the end of the plan year
| Active participants |
2 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
1 |
| 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 |
3 |
| 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 |
2014-07-19 |
| Name of individual signing |
AARON P. CLARK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2014-07-19 |
| Name of individual signing |
AARON P. CLARK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CLARK CHIROPRACTIC CENTER, LLC 401(K) RETIREMENT PLAN
|
2012
|
200759138
|
2013-07-29
|
CLARK CHIROPRACTIC CENTER, LLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2005-01-01
|
| Business code |
621310
|
| Sponsor’s telephone number |
2708529355
|
| Plan sponsor’s mailing address |
P.O. BOX 1394, OWENSBORO, KY, 423021394
|
| Plan sponsor’s
address |
507 EAST PARRISH AVENUE, OWENSBORO, KY, 42303
|
Plan administrator’s name and address
| Administrator’s EIN |
200759138 |
| Plan administrator’s name |
CLARK CHIROPRACTIC CENTER, LLC |
| Plan administrator’s
address |
P.O. BOX 1394, OWENSBORO, KY, 42302 |
| Administrator’s telephone number |
2708529355 |
Number of participants as of the end of the plan year
| Active participants |
2 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
1 |
| 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 |
3 |
| 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 |
2013-07-22 |
| Name of individual signing |
AARON P. CLARK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-07-22 |
| Name of individual signing |
AARON P. CLARK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
