EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2019
|
061588474
|
2020-08-04
|
EYE SURGERY ASSOCIATES, LLC
|
26
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614
|
Signature of
Role |
Plan administrator |
Date |
2020-08-04 |
Name of individual signing |
BRIAN M DEBROFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2018
|
061588474
|
2019-10-02
|
EYE SURGERY ASSOCIATES, LLC
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614
|
Signature of
Role |
Plan administrator |
Date |
2019-10-02 |
Name of individual signing |
BRIAN M DEBROFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2017
|
061588474
|
2018-06-01
|
EYE SURGERY ASSOCIATES, LLC
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614
|
Signature of
Role |
Plan administrator |
Date |
2018-06-01 |
Name of individual signing |
BRIAN M. DEBROFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2016
|
061588474
|
2017-05-21
|
EYE SURGERY ASSOCIATES, LLC
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614
|
Signature of
Role |
Plan administrator |
Date |
2017-05-21 |
Name of individual signing |
BRIAN DEBROFF MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2015
|
061588474
|
2016-06-06
|
EYE SURGERY ASSOCIATES, LLC
|
18
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614
|
Signature of
Role |
Plan administrator |
Date |
2016-06-06 |
Name of individual signing |
BRIAN M DEBROFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2014
|
061588474
|
2015-06-23
|
EYE SURGERY ASSOCIATES, LLC
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614
|
Signature of
Role |
Plan administrator |
Date |
2015-06-23 |
Name of individual signing |
BRIAN DEBROFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2013
|
061588474
|
2014-09-30
|
EYE SURGERY ASSOCIATES, LLC
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614
|
Signature of
Role |
Plan administrator |
Date |
2014-09-30 |
Name of individual signing |
SHIRLEY CORBO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2012
|
061588474
|
2013-07-16
|
EYE SURGERY ASSOCIATES, LLC
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614
|
Signature of
Role |
Plan administrator |
Date |
2013-07-16 |
Name of individual signing |
BRIAN M DEBROFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2011
|
061588474
|
2012-06-12
|
EYE SURGERY ASSOCIATES, LLC
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614
|
Plan administrator’s name and address
Administrator’s EIN |
061588474 |
Plan administrator’s name |
EYE SURGERY ASSOCIATES, LLC |
Plan administrator’s
address |
495 HAWLEY LANE, STRATFORD, CT, 06614 |
Administrator’s telephone number |
2033755819 |
Signature of
Role |
Plan administrator |
Date |
2012-06-12 |
Name of individual signing |
BRIAN M DEBROFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN
|
2010
|
061588474
|
2011-06-17
|
EYE SURGERY ASSOCIATES, LLC
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2033755819
|
Plan sponsor’s
address |
3060 MAIN STREET, STRATFORD, CT, 06614
|
Plan administrator’s name and address
Administrator’s EIN |
061588474 |
Plan administrator’s name |
EYE SURGERY ASSOCIATES, LLC |
Plan administrator’s
address |
3060 MAIN STREET, STRATFORD, CT, 06614 |
Administrator’s telephone number |
2033755819 |
Signature of
Role |
Plan administrator |
Date |
2011-06-17 |
Name of individual signing |
BRIAN M DEBROFF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|