|
THE TILLERS LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT
|
2009
|
362728962
|
2010-07-30
|
THE TILLERS NURSING AND REHABILITATION CENTER
|
101
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
503
|
| Effective date of plan |
2009-01-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
6305541001
|
| Plan sponsor’s mailing address |
4390 ROUTE 71, OSWEGO, IL, 60543
|
| Plan sponsor’s
address |
4390 ROUTE 71, OSWEGO, IL, 60543
|
Plan administrator’s name and address
| Administrator’s EIN |
362728962 |
| Plan administrator’s name |
THE TILLERS NURSING AND REHABILITATION CENTER |
| Plan administrator’s
address |
4390 ROUTE 71, OSWEGO, IL, 60543 |
| Administrator’s telephone number |
6305541001 |
Number of participants as of the end of the plan year
Signature of
| Role |
Plan administrator |
| Date |
2010-07-30 |
| Name of individual signing |
KAREN SCHOENLY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
THE TILLERS NURSING AND REHABILITATION CENTER EMPLOYEES 401K PROFIT SHARING PLAN
|
2009
|
362728962
|
2010-10-14
|
THE TILLERS NURSING AND REHABILITATION CENTER
|
159
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1992-04-05
|
| Business code |
623000
|
| Sponsor’s telephone number |
6305541001
|
| Plan sponsor’s mailing address |
PO BOX 950, OSWEGO, IL, 60543
|
| Plan sponsor’s
address |
4390 ROUTE 71, OSWEGO, IL, 60543
|
Plan administrator’s name and address
| Administrator’s EIN |
362728962 |
| Plan administrator’s name |
THE TILLERS NURSING AND REHABILITATION CENTER |
| Plan administrator’s
address |
PO BOX 950, OSWEGO, IL, 60543 |
| Administrator’s telephone number |
6305541001 |
Number of participants as of the end of the plan year
| Active participants |
145 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
12 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
100 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-13 |
| Name of individual signing |
ROBERT M SAXON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-10-13 |
| Name of individual signing |
ROBERT M SAXON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
