|
CARDIOMEDIX 401(K) PLAN
|
2010
|
363568985
|
2010-08-03
|
CARDIOMEDIX
|
8
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-03-05
|
| Business code |
621510
|
| Sponsor’s telephone number |
8478690075
|
| Plan sponsor’s mailing address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201
|
| Plan sponsor’s
address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201
|
Plan administrator’s name and address
| Administrator’s EIN |
363568985 |
| Plan administrator’s name |
CARDIOMEDIX |
| Plan administrator’s
address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201 |
| Administrator’s telephone number |
8478690075 |
Number of participants as of the end of the plan year
| Active participants |
15 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
3 |
| 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 |
8 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Employer/plan sponsor |
| Date |
2010-08-03 |
| Name of individual signing |
ZIPORA DAVID |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CARDIOMEDIX 401(K) PLAN
|
2009
|
363568985
|
2010-08-04
|
CARDIOMEDIX
|
8
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-03-05
|
| Business code |
621510
|
| Sponsor’s telephone number |
8478690230
|
| Plan sponsor’s mailing address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201
|
| Plan sponsor’s
address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201
|
Plan administrator’s name and address
| Administrator’s EIN |
363568985 |
| Plan administrator’s name |
CARDIOMEDIX |
| Plan administrator’s
address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201 |
| Administrator’s telephone number |
8478690230 |
Number of participants as of the end of the plan year
| Active participants |
15 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
3 |
| 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 |
8 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
DFE |
| Date |
2010-08-04 |
| Name of individual signing |
ZIPORA DAVID |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CARDIOMEDIX 401(K) PLAN
|
2009
|
363568985
|
2010-08-04
|
CARDIOMEDIX
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-03-05
|
| Business code |
621510
|
| Sponsor’s telephone number |
8478690230
|
| Plan sponsor’s mailing address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201
|
| Plan sponsor’s
address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201
|
Plan administrator’s name and address
| Administrator’s EIN |
363568985 |
| Plan administrator’s name |
CARDIOMEDIX INC |
| Plan administrator’s
address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201 |
| Administrator’s telephone number |
8478690230 |
Number of participants as of the end of the plan year
| Active participants |
15 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
3 |
| 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 |
8 |
| 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 |
2010-08-04 |
| Name of individual signing |
CARDIOMEDIX INC |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CARDIOMEDIX 401(K) PLAN
|
2009
|
363568985
|
2010-08-03
|
CARDIOMEDIX
|
8
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-03-05
|
| Business code |
621510
|
| Sponsor’s telephone number |
8478690075
|
| Plan sponsor’s mailing address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201
|
| Plan sponsor’s
address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201
|
Plan administrator’s name and address
| Administrator’s EIN |
363568985 |
| Plan administrator’s name |
CARDIOMEDIX |
| Plan administrator’s
address |
1840 OAK AVE, STE. 218, EVANSTON, IL, 60201 |
| Administrator’s telephone number |
8478690075 |
Number of participants as of the end of the plan year
| Active participants |
15 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
3 |
| 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 |
8 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Employer/plan sponsor |
| Date |
2010-08-03 |
| Name of individual signing |
ZIPORA DAVID |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
