PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2018
|
362689985
|
2019-07-16
|
PERIODONTICS & IMPLANTS, LTD.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1970-03-02
|
Business code |
621210
|
Sponsor’s telephone number |
8474911880
|
Plan sponsor’s
address |
636 CHURCH STREET, EVANSTON, IL, 60201
|
Signature of
Role |
Plan administrator |
Date |
2019-07-16 |
Name of individual signing |
RICHARD C. PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2017
|
362689985
|
2018-07-13
|
PERIODONTICS & IMPLANTS, LTD.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1970-03-02
|
Business code |
621210
|
Sponsor’s telephone number |
8474911880
|
Plan sponsor’s
address |
636 CHURCH STREET, EVANSTON, IL, 60201
|
Signature of
Role |
Plan administrator |
Date |
2018-07-13 |
Name of individual signing |
RICHARD C. PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2016
|
362689985
|
2017-07-26
|
PERIODONTICS & IMPLANTS, LTD.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1970-03-02
|
Business code |
621210
|
Sponsor’s telephone number |
8474911880
|
Plan sponsor’s
address |
636 CHURCH STREET, EVANSTON, IL, 60201
|
Signature of
Role |
Plan administrator |
Date |
2017-07-26 |
Name of individual signing |
RICHARD C. PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2015
|
362689985
|
2016-07-13
|
PERIODONTICS & IMPLANTS, LTD.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1970-03-02
|
Business code |
621210
|
Sponsor’s telephone number |
8474911880
|
Plan sponsor’s
address |
636 CHURCH STREET, EVANSTON, IL, 60201
|
Signature of
Role |
Plan administrator |
Date |
2016-07-13 |
Name of individual signing |
RICHARD C. PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2014
|
362689985
|
2015-07-09
|
PERIODONTICS & IMPLANTS, LTD.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1970-03-02
|
Business code |
621210
|
Sponsor’s telephone number |
8474911880
|
Plan sponsor’s
address |
636 CHURCH STREET, EVANSTON, IL, 60201
|
Signature of
Role |
Plan administrator |
Date |
2015-07-09 |
Name of individual signing |
RICHARD C. PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2013
|
362689985
|
2014-07-25
|
PERIODONTICS & IMPLANTS, LTD.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1970-03-02
|
Business code |
621210
|
Plan sponsor’s
address |
636 CHURCH STREET, EVANSTON, IL, 60201
|
Signature of
Role |
Plan administrator |
Date |
2014-07-24 |
Name of individual signing |
RICHARD C. PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2012
|
362689985
|
2013-09-24
|
PERIODONTICS & IMPLANTS, LTD.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1970-03-02
|
Business code |
621210
|
Plan sponsor’s
address |
636 CHURCH STREET, EVANSTON, IL, 60201
|
Signature of
Role |
Plan administrator |
Date |
2013-09-23 |
Name of individual signing |
RICHARD PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-09-23 |
Name of individual signing |
RICHARD PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LARSON & DARBY, INC. PROFIT SHARING PLAN
|
2012
|
362667316
|
2013-04-25
|
LARSON & DARBY, INC.
|
65
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1972-02-01
|
Business code |
541310
|
Sponsor’s telephone number |
8154840739
|
Plan sponsor’s
address |
4949 HARRISON AVENUE, ROCKFORD, IL, 61108
|
Signature of
Role |
Plan administrator |
Date |
2013-04-25 |
Name of individual signing |
WILLIAM WALDORF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2011
|
362689985
|
2012-07-19
|
PERIODONTICS & IMPLANTS, LTD.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1970-03-02
|
Business code |
621210
|
Plan sponsor’s
address |
636 CHURCH STREET, EVANSTON, IL, 60201
|
Plan administrator’s name and address
Administrator’s EIN |
362689985 |
Plan administrator’s name |
PERIODONTICS & IMPLANTS, LTD. |
Plan administrator’s
address |
636 CHURCH STREET, EVANSTON, IL, 60201 |
Signature of
Role |
Plan administrator |
Date |
2012-07-17 |
Name of individual signing |
RICHARD PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-17 |
Name of individual signing |
RICHARD PRENDERGAST |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LARSON & DARBY, INC. PROFIT SHARING PLAN
|
2011
|
362667316
|
2012-10-11
|
LARSON & DARBY, INC.
|
64
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1972-02-01
|
Business code |
541310
|
Sponsor’s telephone number |
8154840739
|
Plan sponsor’s
address |
4949 HARRISON AVENUE, ROCKFORD, IL, 61108
|
Plan administrator’s name and address
Administrator’s EIN |
362667316 |
Plan administrator’s name |
LARSON & DARBY, INC. |
Plan administrator’s
address |
4949 HARRISON AVENUE, ROCKFORD, IL, 61108 |
Administrator’s telephone number |
8154840739 |
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
WILLIAM WALDORF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|