SPRINGHURST PEDIATRICS RETIREMENT PLAN
|
2019
|
562486896
|
2020-01-24
|
SPRINGHURST PEDIATRICS, PLLC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5023390444
|
Plan sponsor’s
address |
SELMA WINNER, MD, 3516 RIDGE TOP CT, LOUISVILLE, KY, 402416216
|
Signature of
Role |
Plan administrator |
Date |
2020-01-24 |
Name of individual signing |
SELMA WINNER, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPRINGHURST PEDIATRICS RETIREMENT PLAN
|
2018
|
562486896
|
2019-07-08
|
SPRINGHURST PEDIATRICS, PLLC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5023390444
|
Plan sponsor’s
address |
3516 RIDGE TOP CT, LOUISVILLE, KY, 402416216
|
Signature of
Role |
Plan administrator |
Date |
2019-07-02 |
Name of individual signing |
SELMA WINNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPRINGHURST PEDIATRICS RETIREMENT PLAN
|
2017
|
562486896
|
2018-10-01
|
SPRINGHURST PEDIATRICS, PLLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5023390444
|
Plan sponsor’s
address |
3516 RIDGE TOP CT, LOUISVILLE, KY, 402416216
|
Signature of
Role |
Plan administrator |
Date |
2018-10-01 |
Name of individual signing |
SELMA WINNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-01 |
Name of individual signing |
SELMA WINNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPRINGHURST PEDIATRICS RETIREMENT PLAN
|
2016
|
562486896
|
2017-07-27
|
SPRINGHURST PEDIATRICS PLLC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5023390444
|
Plan sponsor’s
address |
3516 RIDGE TOP CT, LOUISVILLE, KY, 40241
|
Signature of
Role |
Plan administrator |
Date |
2017-07-27 |
Name of individual signing |
SELMA WINNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-27 |
Name of individual signing |
SELMA WINNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPRINGHURST PEDIATRICS RETIREMENT PLAN
|
2016
|
562486896
|
2018-10-01
|
SPRINGHURST PEDIATRICS PLLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5023390444
|
Plan sponsor’s
address |
3516 RIDGE TOP CT, LOUISVILLE, KY, 402416216
|
Signature of
Role |
Plan administrator |
Date |
2018-10-01 |
Name of individual signing |
SELMA WINNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-01 |
Name of individual signing |
SELMA WINNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPRINGHURST PEDIATRICS, RETIREMENT PLAN
|
2009
|
562486896
|
2010-10-01
|
SPRINGHURST PEDIATRICS, PLLC
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2008-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
5023390444
|
Plan sponsor’s
address |
10210 WESTPORT ROAD, LOUISVILLE, KY, 40241
|
Plan administrator’s name and address
Administrator’s EIN |
562486896 |
Plan administrator’s name |
SPRINGHURST PEDIATRICS, PLLC |
Plan administrator’s
address |
10210 WESTPORT ROAD, LOUISVILLE, KY, 40241 |
Administrator’s telephone number |
5023390444 |
Signature of
Role |
Plan administrator |
Date |
2010-10-01 |
Name of individual signing |
SELMA WINNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|