| Plan Name | 401K EMPLOYEE RETIREMENT PLAN |
| Plan identification number | 005 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | NORTH JACKSON MEDICAL CLINIC, PLLC |
| Employer identification number (EIN): | 640912506 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 005 | 2012-06-01 | SCOTT HILL | 2013-07-31 |