FORSYTH INSURANCE GROUP INC 401(K) PLAN
|
2012
|
370818892
|
2013-05-14
|
FORSYTH INSURANCE GROUP
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2001-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
2175259500
|
Plan sponsor’s
address |
PO BOX 2229, SPRINGFIELD, IL, 627032229
|
Plan administrator’s name and address
Administrator’s EIN |
370818892 |
Plan administrator’s name |
FORSYTH INSURANCE GROUP |
Plan administrator’s
address |
PO BOX 2229, SPRINGFIELD, IL, 627032229 |
Administrator’s telephone number |
2175259500 |
Signature of
Role |
Plan administrator |
Date |
2013-05-14 |
Name of individual signing |
DANIEL CHEATHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORSYTH INSURANCE GROUP INC 401(K) PLAN
|
2011
|
370818892
|
2012-05-16
|
FORSYTH INSURANCE GROUP
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2001-01-01
|
Business code |
524210
|
Plan sponsor’s
address |
PO BOX 2229, SPRINGFIELD, IL, 627032229
|
Plan administrator’s name and address
Administrator’s EIN |
370818892 |
Plan administrator’s name |
FORSYTH INSURANCE GROUP |
Plan administrator’s
address |
PO BOX 2229, SPRINGFIELD, IL, 627032229 |
Administrator’s telephone number |
2175259500 |
Signature of
Role |
Plan administrator |
Date |
2012-05-16 |
Name of individual signing |
DANIEL CHEATHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORSYTH INSURANCE GROUP INC 401(K) PLAN
|
2010
|
370818892
|
2011-04-14
|
FORSYTH INSURANCE GROUP
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2001-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
2175259500
|
Plan sponsor’s
address |
PO BOX 2229, SPRINGFIELD, IL, 627032229
|
Plan administrator’s name and address
Administrator’s EIN |
370818892 |
Plan administrator’s name |
FORSYTH INSURANCE GROUP |
Plan administrator’s
address |
PO BOX 2229, SPRINGFIELD, IL, 627032229 |
Administrator’s telephone number |
2175259500 |
Signature of
Role |
Plan administrator |
Date |
2011-04-14 |
Name of individual signing |
DANIEL CHEATHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-04-14 |
Name of individual signing |
DANIEL CHEATHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORSYTH INSURANCE GROUP INC 401(K) PLAN
|
2009
|
370818892
|
2010-07-20
|
FORSYTH INSURANCE GROUP
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2001-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
2175259500
|
Plan sponsor’s
address |
PO BOX 2229, SPRINGFIELD, IL, 627032229
|
Plan administrator’s name and address
Administrator’s EIN |
370818892 |
Plan administrator’s name |
FORSYTH INSURANCE GROUP |
Plan administrator’s
address |
PO BOX 2229, SPRINGFIELD, IL, 627032229 |
Administrator’s telephone number |
2175259500 |
Signature of
Role |
Plan administrator |
Date |
2010-07-20 |
Name of individual signing |
DANIEL CHEATHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-20 |
Name of individual signing |
DANIEL CHEATHAM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|