JOHN DREW GORRELL DDS LTD 401(K) PROFIT SHARING PLAN AND TRUST
|
2014
|
363058389
|
2015-09-17
|
JOHN DREW GORRELL DDS LTD
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473645100
|
Plan
sponsor’s DBA name |
VILLAGE DENTAL
|
Plan sponsor’s
address |
958 ELK GROVE TOWN CENTER, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363058389 |
Plan administrator’s name |
MARK E KLEIN |
Plan administrator’s
address |
958 ELK GROVE TOWN CENTER, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8473645100 |
Signature of
Role |
Plan administrator |
Date |
2015-09-17 |
Name of individual signing |
MARK KLEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JOHN DREW GORRELL DDS LTD 401(K) PROFIT SHARING PLAN AND TRUST
|
2014
|
363058389
|
2015-06-05
|
JOHN DREW GORRELL DDS LTD
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473645100
|
Plan sponsor’s
address |
958 ELK GROVE TOWN CENTER, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363058389 |
Plan administrator’s name |
MARK E KLEIN |
Plan administrator’s
address |
958 ELK GROVETOWN CENTER, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8473645100 |
Signature of
Role |
Plan administrator |
Date |
2015-06-05 |
Name of individual signing |
MARK KLEIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JOHN DREW GORRELL DDS LTD 401 K PROFIT SHARING PLAN TRUST
|
2013
|
363058389
|
2014-05-13
|
JOHN DREW GORRELL DDS LTD
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473645100
|
Plan sponsor’s
address |
958 ELK GROVE TOWN CTR, ELK GROVE VILLAGE, IL, 600073754
|
Signature of
Role |
Plan administrator |
Date |
2014-05-13 |
Name of individual signing |
MAUREEN GORRELL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JOHN DREW GORRELL DDS LTD 401 K PROFIT SHARING PLAN TRUST
|
2012
|
363058389
|
2013-06-19
|
JOHN DREW GORRELL DDS LTD
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473645100
|
Plan sponsor’s
address |
958 ELK GROVE TOWN CTR, ELK GROVE VILLAGE, IL, 600073754
|
Signature of
Role |
Plan administrator |
Date |
2013-06-19 |
Name of individual signing |
JOHN DREW GORRELL DDS LTD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JOHN DREW GORRELL DDS LTD 401 K PROFIT SHARING PLAN TRUST
|
2011
|
363058389
|
2012-06-07
|
JOHN DREW GORRELL DDS LTD
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473645100
|
Plan sponsor’s
address |
958 ELK GROVE TOWN CTR, ELK GROVE VILLAGE, IL, 600073754
|
Plan administrator’s name and address
Administrator’s EIN |
363058389 |
Plan administrator’s name |
JOHN DREW GORRELL DDS LTD |
Plan administrator’s
address |
958 ELK GROVE TOWN CTR, ELK GROVE VILLAGE, IL, 600073754 |
Administrator’s telephone number |
8473645100 |
Signature of
Role |
Plan administrator |
Date |
2012-06-07 |
Name of individual signing |
JOHN DREW GORRELL DDS LTD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|