| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-09-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6182883384
|
| Plan sponsor’s
address |
2023 VADALABENE DRIVE, SUITE 252, MARYVILLE, IL, 62025
|
Plan administrator’s name and address
| Administrator’s EIN |
262766377 |
| Plan administrator’s name |
BRINLEY ORTHODONTICS |
| Plan administrator’s
address |
2023 VADALABENE DRIVE, SUITE 252, MARYVILLE, IL, 62025 |
| Administrator’s telephone number |
6182883384 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-17 |
| Name of individual signing |
CHRISTINE BRINLEY-MATRAS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-07-17 |
| Name of individual signing |
CHRISTINE BRINLEY-MATRAS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
