WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2015
|
630921944
|
2016-05-17
|
WILL R. CROUCH, M.D., P.C.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2567739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Signature of
Role |
Plan administrator |
Date |
2016-05-17 |
Name of individual signing |
WILL R. CROUCH, MD |
|
|
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2014
|
630921944
|
2015-06-29
|
WILL R. CROUCH, M.D., P.C.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2567739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Signature of
Role |
Plan administrator |
Date |
2015-06-29 |
Name of individual signing |
WILL R. CROUCH, MD |
|
|
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2013
|
630921944
|
2014-03-19
|
WILL R. CROUCH, M.D., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2567739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Signature of
Role |
Plan administrator |
Date |
2014-03-19 |
Name of individual signing |
WILL R. CROUCH, MD |
|
|
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2012
|
630921944
|
2013-09-18
|
WILL R. CROUCH, M.D., P.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2567739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Signature of
Role |
Plan administrator |
Date |
2013-09-18 |
Name of individual signing |
WILL R. CROUCH, MD |
|
|
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2011
|
630921944
|
2012-09-19
|
WILL R. CROUCH, M.D., P.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2567739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Plan administrator’s name and address
Administrator’s EIN |
630921944 |
Plan administrator’s name |
WILL R. CROUCH, M.D., P.C. |
Plan administrator’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640 |
Administrator’s telephone number |
2567739089 |
Signature of
Role |
Plan administrator |
Date |
2012-09-19 |
Name of individual signing |
WILL CROUCH |
|
|
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2010
|
630921944
|
2011-10-17
|
WILL R. CROUCH, M.D., P.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2057739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Plan administrator’s name and address
Administrator’s EIN |
630921944 |
Plan administrator’s name |
WILL R. CROUCH, M.D., P.C. |
Plan administrator’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640 |
Administrator’s telephone number |
2057739089 |
Signature of
Role |
Plan administrator |
Date |
2011-10-17 |
Name of individual signing |
WILL R. CROUCH, MD |
|
|
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2010
|
630921944
|
2011-10-14
|
WILL R. CROUCH, M.D., P.C.
|
5
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2057739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Plan administrator’s name and address
Administrator’s EIN |
630921944 |
Plan administrator’s name |
WILL R. CROUCH, M.D., P.C. |
Plan administrator’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640 |
Administrator’s telephone number |
2057739089 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
WILL R. CROUCH, MD |
|
|
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2009
|
630921944
|
2010-07-20
|
WILL R. CROUCH, M.D., P.C.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2057739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Plan administrator’s name and address
Administrator’s EIN |
630921944 |
Plan administrator’s name |
WILL R. CROUCH, M.D., P.C. |
Plan administrator’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640 |
Administrator’s telephone number |
2057739089 |
Signature of
Role |
Plan administrator |
Date |
2010-07-19 |
Name of individual signing |
WILL R. CROUCH, MD |
|
|
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2009
|
630921944
|
2010-07-13
|
WILL R. CROUCH, M.D., P.C.
|
4
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2057739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Plan administrator’s name and address
Administrator’s EIN |
630921944 |
Plan administrator’s name |
WILL R. CROUCH, M.D., P.C. |
Plan administrator’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640 |
Administrator’s telephone number |
2057739089 |
Signature of
Role |
Plan administrator |
Date |
2010-07-13 |
Name of individual signing |
KENT QUINN |
|
|
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN
|
2009
|
630921944
|
2010-07-12
|
WILL R. CROUCH, M.D., P.C.
|
4
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1986-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
2057739089
|
Plan sponsor’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640
|
Plan administrator’s name and address
Administrator’s EIN |
630921944 |
Plan administrator’s name |
WILL R. CROUCH, M.D., P.C. |
Plan administrator’s
address |
301 PINE STREET SW, HARTSELLE, AL, 35640 |
Administrator’s telephone number |
2057739089 |
Signature of
Role |
Plan administrator |
Date |
2010-07-12 |
Name of individual signing |
WILL R. CROUCH, MD |
|
Role |
Employer/plan sponsor |
Date |
2010-07-12 |
Name of individual signing |
WILL R. CROUCH, MD |
|
|