BURRIS MANAGEMENT, INC.

Company Details

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

BURRIS MANAGEMENT MEDOVA LIFESTYLE HEALTH PLAN

2022

371393059

2024-06-16

BURRIS MANAGEMENT

Plan administrator’s name and address

Administrator’s EIN	200200514
Plan administrator’s name	RECEIVERSHIP MANAGEMENT, INC.
Plan administrator’s address	510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number	6153700051

Signature of

Role	Plan administrator
Date	2024-06-16
Name of individual signing	ROBERT MOORE
Valid signature	Filed with authorized/valid electronic signature

BURRIS MANAGEMENT MEDOVA LIFESTYLE HEALTH PLAN

2020

371393059

2022-04-12

BURRIS MANAGEMENT

Plan administrator’s name and address

Administrator’s EIN	200200514
Plan administrator’s name	RECEIVERSHIP MANAGEMENT INC
Plan administrator’s address	510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number	6153700051

Signature of

Role	Plan administrator
Date	2022-02-19
Name of individual signing	ROBERT MOORE
Valid signature	Filed with authorized/valid electronic signature

Name and Address	Role	Appointment Date
ALAN E STUMPF, 222 S MAIN ST PO BOX 228, COLUMBIA, 62298, MONROE	Agent	1999-12-30

Name and Address	Role
WILLIAM E BURRIS, 8054 LAKEWOOD DRIVE WATERLOO 62298	President

Name and Address	Role
JAMIE S BURRIS	Secretary

Class	Series	Voting Rights	Authorized Shares	Issued Shares	Par Value
COMMON	No data	Voting Rights	100000	1000000	0.01

Date of last update: 13 Jan 2025