|
WESTEN LLC DBA IMPELLIZZERI'S PIZZA MEDOVA LIFESTYLE HEALTH PLAN
|
2022
|
753228763
|
2024-08-31
|
WESTEN LLC
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2021-01-01
|
| Business code |
722513
|
| Sponsor’s telephone number |
5025894900
|
| Plan
sponsor’s DBA name |
IMPELLIZZERI'S PIZZA
|
| Plan sponsor’s
address |
PO BOX 22062, LOUISVILLE, KY, 402520062
|
Plan administrator’s name and address
| Administrator’s EIN |
200200514 |
| Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number |
6153700051 |
Signature of
| Role |
Plan administrator |
| Date |
2024-08-31 |
| Name of individual signing |
ROBERT MOORE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
WESTEN LLC DBA IMPELLIZZERI'S PIZZA MEDOVA LIFESTYLE HEALTH PLAN
|
2021
|
753228763
|
2024-07-22
|
WESTEN LLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2021-01-01
|
| Business code |
722513
|
| Sponsor’s telephone number |
5025894900
|
| Plan
sponsor’s DBA name |
IMPELLIZZERI'S PIZZA
|
| Plan sponsor’s
address |
PO BOX 22062, LOUISVILLE, KY, 402520062
|
Plan administrator’s name and address
| Administrator’s EIN |
200200514 |
| Plan administrator’s name |
RECEIVERSHIP MANAGEMENT, INC. |
| Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number |
6153700051 |
Signature of
| Role |
Plan administrator |
| Date |
2024-07-22 |
| Name of individual signing |
JACQUELINE LAWSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
WESTEN LLC DBA IMPELLIZZERI'S PIZZA MEDOVA LIFESTYLE HEALTH PLAN
|
2021
|
262172841
|
2022-10-16
|
WESTEN LLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2021-01-01
|
| Business code |
722513
|
| Sponsor’s telephone number |
5025894900
|
| Plan
sponsor’s DBA name |
IMPELLIZZERI'S PIZZA
|
| Plan sponsor’s
address |
PO BOX 22062, LOUISVILLE, KY, 402520062
|
Plan administrator’s name and address
| Administrator’s EIN |
200200514 |
| Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number |
6153700051 |
Signature of
| Role |
Plan administrator |
| Date |
2022-10-15 |
| Name of individual signing |
ROBERT MOORE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
