EVANS TOTAL CARE, LLC 401(K) PLAN
|
2016
|
431986967
|
2017-07-07
|
EVANS TOTAL CARE, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
2704722421
|
Plan sponsor’s
address |
208 LAKE STREET, FULTON, KY, 42041
|
|
EVANS TOTAL CARE, LLC 401(K) PLAN
|
2015
|
431986967
|
2016-09-23
|
EVANS TOTAL CARE, LLC
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
2704722421
|
Plan sponsor’s
address |
208 LAKE STREET, FULTON, KY, 42041
|
|
EVANS TOTAL CARE, LLC 401(K) PLAN
|
2014
|
431986967
|
2015-08-17
|
EVANS TOTAL CARE, LLC
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
2704722421
|
Plan sponsor’s
address |
208 LAKE STREET, FULTON, KY, 42041
|
|
EVANS TOTAL CARE, LLC 401(K) PLAN
|
2013
|
431986967
|
2014-04-18
|
EVANS TOTAL CARE, LLC
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
2704722421
|
Plan sponsor’s
address |
208 LAKE STREET, FULTON, KY, 42041
|
Signature of
Role |
Plan administrator |
Date |
2014-04-18 |
Name of individual signing |
DAVID PRATER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EVANS TOTAL CARE, LLC 401(K) PLAN
|
2012
|
431986967
|
2013-07-29
|
EVANS TOTAL CARE, LLC
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
2704722421
|
Plan sponsor’s
address |
208 LAKE STREET, FULTON, KY, 42041
|
Signature of
Role |
Plan administrator |
Date |
2013-07-29 |
Name of individual signing |
MARY NIEUWSMA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EVANS TOTAL CARE, LLC 401(K) PLAN
|
2011
|
431986967
|
2012-07-23
|
EVANS TOTAL CARE, LLC
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
2704722421
|
Plan sponsor’s
address |
208 LAKE STREET, FULTON, KY, 42041
|
Plan administrator’s name and address
Administrator’s EIN |
431986967 |
Plan administrator’s name |
EVANS TOTAL CARE, LLC |
Plan administrator’s
address |
208 LAKE STREET, FULTON, KY, 42041 |
Administrator’s telephone number |
2704722421 |
Signature of
Role |
Plan administrator |
Date |
2012-07-23 |
Name of individual signing |
MARY NIEUWSMA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EVANS TOTAL CARE, LLC 401(K) PLAN
|
2010
|
431986967
|
2011-09-08
|
EVANS TOTAL CARE, LLC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
2704722421
|
Plan sponsor’s
address |
208 LAKE STREET, FULTON, KY, 42041
|
Plan administrator’s name and address
Administrator’s EIN |
431986967 |
Plan administrator’s name |
EVANS TOTAL CARE, LLC |
Plan administrator’s
address |
208 LAKE STREET, FULTON, KY, 42041 |
Administrator’s telephone number |
2704722421 |
Signature of
Role |
Plan administrator |
Date |
2011-09-08 |
Name of individual signing |
MARY NIEUWSMA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EVANS TOTAL CARE, LLC 401(K) PLAN
|
2009
|
431986967
|
2010-10-07
|
EVANS TOTAL CARE, LLC
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
2704722421
|
Plan sponsor’s
address |
208 LAKE STREET, FULTON, KY, 42041
|
Plan administrator’s name and address
Administrator’s EIN |
431986967 |
Plan administrator’s name |
EVANS TOTAL CARE, LLC |
Plan administrator’s
address |
208 LAKE STREET, FULTON, KY, 42041 |
Administrator’s telephone number |
2704722421 |
Signature of
Role |
Plan administrator |
Date |
2010-10-07 |
Name of individual signing |
DAVID PRATER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-07 |
Name of individual signing |
DAVID PRATER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|