|
COUNTRY CLUB INC. RETIREMENT PLAN
|
2010
|
050125260
|
2010-11-15
|
COUNTRY CLUB INC.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
812320
|
| Sponsor’s telephone number |
4012453400
|
| Plan sponsor’s
address |
260 CHILD STREET, WARREN, RI, 02885
|
Plan administrator’s name and address
| Administrator’s EIN |
050125260 |
| Plan administrator’s name |
COUNTRY CLUB INC. |
| Plan administrator’s
address |
260 CHILD STREET, WARREN, RI, 02885 |
| Administrator’s telephone number |
4012453400 |
Signature of
| Role |
Plan administrator |
| Date |
2010-11-15 |
| Name of individual signing |
PAUL BAGGOTT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-11-15 |
| Name of individual signing |
PAUL BAGGOTT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
COUNTRY CLUB INC. RETIREMENT PLAN
|
2009
|
050125260
|
2010-10-12
|
COUNTRY CLUB INC.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
812320
|
| Sponsor’s telephone number |
4012453400
|
| Plan sponsor’s
address |
260 CHILD STREET, WARREN, RI, 02885
|
Plan administrator’s name and address
| Administrator’s EIN |
050125260 |
| Plan administrator’s name |
COUNTRY CLUB INC. |
| Plan administrator’s
address |
260 CHILD STREET, WARREN, RI, 02885 |
| Administrator’s telephone number |
4012453400 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-12 |
| Name of individual signing |
PAUL J. BAGGOTT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-10-12 |
| Name of individual signing |
PAUL J. BAGGOTT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
