FREEBURG CARE CENTER 401(K) PROFIT SHARING PLAN
|
2012
|
371062186
|
2013-07-19
|
FREEBURG CARE CENTER
|
42
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
623000
|
Sponsor’s telephone number |
6185395856
|
Plan sponsor’s
address |
746 URBANNA DRIVE, FREEBURG, IL, 62243
|
Signature of
Role |
Plan administrator |
Date |
2013-07-19 |
Name of individual signing |
BRENDA CULLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-19 |
Name of individual signing |
BRENDA CULLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FREEBURG CARE CENTER, INC. 401K PLAN
|
2011
|
371062186
|
2012-07-11
|
FREEBURG CARE CENTER, INC.
|
36
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
623000
|
Sponsor’s telephone number |
6185395856
|
Plan sponsor’s
address |
746 URBANNA DRIVE, FREEBURG, IL, 622431904
|
Plan administrator’s name and address
Administrator’s EIN |
371062186 |
Plan administrator’s name |
FREEBURG CARE CENTER, INC. |
Plan administrator’s
address |
746 URBANNA DRIVE, FREEBURG, IL, 622431904 |
Administrator’s telephone number |
6185395856 |
Signature of
Role |
Plan administrator |
Date |
2012-07-11 |
Name of individual signing |
BRENDA CULLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-11 |
Name of individual signing |
BRENDA CULLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FREEBURG CARE CENTER, INC. 401K PLAN
|
2010
|
371062186
|
2011-09-29
|
FREEBURG CARE CENTER, INC.
|
34
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
623000
|
Sponsor’s telephone number |
6185395856
|
Plan sponsor’s
address |
746 URBANNA DRIVE, FREEBURG, IL, 622431904
|
Plan administrator’s name and address
Administrator’s EIN |
371062186 |
Plan administrator’s name |
FREEBURG CARE CENTER, INC. |
Plan administrator’s
address |
746 URBANNA DRIVE, FREEBURG, IL, 622431904 |
Administrator’s telephone number |
6185395856 |
Signature of
Role |
Plan administrator |
Date |
2011-09-29 |
Name of individual signing |
BRENDA CULLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-09-29 |
Name of individual signing |
BRENDA CULLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FREEBURG CARE CENTER, INC. 401(K) PLAN
|
2009
|
371062186
|
2010-07-26
|
FREEBURG CARE CENTER, INC.
|
34
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
623000
|
Sponsor’s telephone number |
6185395856
|
Plan sponsor’s
address |
746 URBANNA DRIVE, FREEBURG, IL, 622431904
|
Plan administrator’s name and address
Administrator’s EIN |
371062186 |
Plan administrator’s name |
FREEBURG CARE CENTER, INC. |
Plan administrator’s
address |
746 URBANNA DRIVE, FREEBURG, IL, 622431904 |
Administrator’s telephone number |
6185395856 |
Signature of
Role |
Plan administrator |
Date |
2010-07-26 |
Name of individual signing |
BRENDA CULLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-26 |
Name of individual signing |
BRENDA CULLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|