D LINES INC EMPLOYEE GROUP HEALTH PLAN
|
2020
|
371189739
|
2021-07-02
|
D LINES, INC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
6184835471
|
Plan sponsor’s
address |
PO BOX 217, ALTAMONT, IL, 624110217
|
Signature of
Role |
Plan administrator |
Date |
2021-07-02 |
Name of individual signing |
CATHI VOELKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
D LINES INC EMPLOYEE GROUP HEALTH PLAN
|
2019
|
371189739
|
2020-08-04
|
D LINES, INC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
6184835471
|
Plan sponsor’s
address |
PO BOX 217, ALTAMONT, IL, 624110217
|
Signature of
Role |
Plan administrator |
Date |
2020-08-04 |
Name of individual signing |
CATHI VOELKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
D LINES INC EMPLOYEE GROUP HEALTH PLAN
|
2018
|
371189739
|
2019-06-25
|
D LINES, INC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2018-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
6184835471
|
Plan sponsor’s
address |
PO BOX 217, ALTAMONT, IL, 624110217
|
Signature of
Role |
Plan administrator |
Date |
2019-06-25 |
Name of individual signing |
CATHI VOELKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
D LINES INC EMPLOYEE GROUP HEALTH PLAN
|
2017
|
371189739
|
2018-06-06
|
D LINES INC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2017-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
6184835471
|
Plan sponsor’s
address |
2936 E 800TH AVE, ALTAMONT, IL, 624112397
|
Signature of
Role |
Plan administrator |
Date |
2018-06-06 |
Name of individual signing |
CATHI VOELKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-06 |
Name of individual signing |
CATHI VOELKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
D LINES INC EMPLOYEE GROUP HEALTH PLAN
|
2016
|
371189739
|
2017-06-23
|
D LINES INC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
484200
|
Sponsor’s telephone number |
6184835471
|
Plan sponsor’s
address |
2936 E 800TH AVE, ALTAMONT, IL, 624112397
|
Signature of
Role |
Plan administrator |
Date |
2017-06-23 |
Name of individual signing |
CATHI VOELKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
D LINES INC EMPLOYEE GROUP HEALTH PLAN
|
2015
|
371189739
|
2016-07-25
|
D LINES INC.
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-02-01
|
Business code |
484200
|
Plan sponsor’s
address |
2936 E 800TH AVE, ALTAMONT, IL, 624112397
|
Signature of
Role |
Plan administrator |
Date |
2016-07-25 |
Name of individual signing |
CATHI VOELKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|