|
CHARLES F. YEAGLE, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2011
|
412130837
|
2012-10-13
|
CHARLES F. YEAGLE, M.D., P.C.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7198461700
|
| Plan sponsor’s
address |
P.O. BOX 783, TRINIDAD, CO, 81082
|
Plan administrator’s name and address
| Administrator’s EIN |
412130837 |
| Plan administrator’s name |
CHARLES F. YEAGLE, M.D.,M P.C. |
| Plan administrator’s
address |
P.O. BOX 783, TRINIDAD, CO, 81082 |
| Administrator’s telephone number |
7198461700 |
Signature of
| Role |
Plan administrator |
| Date |
2012-10-13 |
| Name of individual signing |
CHARLES F. YEAGLE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHARLES F. YEAGLE, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2010
|
412130837
|
2011-04-26
|
CHARLES F. YEAGLE, M.D., P.C.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7198461700
|
| Plan sponsor’s
address |
400 BENEDICTA AVENUE, SUITE F, TRINIDAD, CO, 81082
|
Plan administrator’s name and address
| Administrator’s EIN |
412130837 |
| Plan administrator’s name |
CHARLES F. YEAGLE, M.D., P.C. |
| Plan administrator’s
address |
400 BENEDICTA AVENUE, SUITE F, TRINIDAD, CO, 81082 |
| Administrator’s telephone number |
7198461700 |
Signature of
| Role |
Plan administrator |
| Date |
2011-04-26 |
| Name of individual signing |
SANDY ALBERT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHARLES F. YEAGLE, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2009
|
412130837
|
2010-09-10
|
CHARLES F. YEAGLE, M.D., P.C.
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7198461700
|
| Plan sponsor’s
address |
400 BENEDICTA AVENUE, SUITE F, TRINIDAD, CO, 81082
|
Plan administrator’s name and address
| Administrator’s EIN |
412130837 |
| Plan administrator’s name |
CHARLES F. YEAGLE, M.D., P.C. |
| Plan administrator’s
address |
400 BENEDICTA AVENUE, SUITE F, TRINIDAD, CO, 81082 |
| Administrator’s telephone number |
7198461700 |
Signature of
| Role |
Plan administrator |
| Date |
2010-09-10 |
| Name of individual signing |
CHARLES F. YEAGLE, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHARLES F. YEAGLE, M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2009
|
412130837
|
2010-08-05
|
CHARLES F. YEAGLE, M.D., P.C.
|
5
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-05-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
7198461700
|
| Plan sponsor’s
address |
400 BENEDICTA AVENUE, SUITE F, TRINIDAD, CO, 81082
|
Plan administrator’s name and address
| Administrator’s EIN |
412130837 |
| Plan administrator’s name |
CHARLES F. YEAGLE, M.D., P.C. |
| Plan administrator’s
address |
400 BENEDICTA AVENUE, SUITE F, TRINIDAD, CO, 81082 |
| Administrator’s telephone number |
7198461700 |
Signature of
| Role |
Employer/plan sponsor |
| Date |
2010-08-05 |
| Name of individual signing |
CHARLES F YEAGLE MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
