|
CHAMBERLAIN CLINIC PLAN 401(K) PLAN
|
2016
|
453576417
|
2017-03-27
|
CHAMBERLAIN CLINIC PLLC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8597448324
|
| Plan sponsor’s
address |
PO BOX 120, WINCHESTER, KY, 403920120
|
Signature of
| Role |
Plan administrator |
| Date |
2017-03-27 |
| Name of individual signing |
RICHARD CHAMBERLAIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHAMBERLAIN CLINIC PLLC 401K PLAN
|
2015
|
453576417
|
2016-07-15
|
CHAMBERLAIN CLINIC PLLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8597448324
|
| Plan sponsor’s
address |
PO BOX 120, WINCHESTER, KY, 403920120
|
Signature of
| Role |
Plan administrator |
| Date |
2016-07-15 |
| Name of individual signing |
RICHARD CHAMBERLAIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2016-07-15 |
| Name of individual signing |
RICHARD CHAMBERLAIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHAIMBERLAIN CLINIC PLLC 401K PLAN
|
2014
|
453576417
|
2015-06-24
|
CHAMBERLAIN CLINIC PLLC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8597448324
|
| Plan sponsor’s
address |
PO BOX 120, WINCHESTER, KY, 403920120
|
Signature of
| Role |
Plan administrator |
| Date |
2015-06-24 |
| Name of individual signing |
LAURA CHAMBERLAIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2015-06-24 |
| Name of individual signing |
LAURA CHAMBERLAIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHAMBERLAIN CLINIC PLLC 401K PLAN
|
2013
|
453576417
|
2014-05-23
|
CHAMBERLAIN CLINIC PLLC
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2009-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8597448324
|
| Plan sponsor’s
address |
PO BOX 120, WINCHESTER, KY, 403920120
|
Signature of
| Role |
Plan administrator |
| Date |
2014-05-23 |
| Name of individual signing |
LAURA CHAMBERLAIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2014-05-23 |
| Name of individual signing |
LAURA CHAMBERLAIN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
