CARY J. BORTNICK, M.D., LTD. CASH BALANCE PENSION PLAN & TRUST
|
2012
|
363431285
|
2013-10-02
|
CARY J. BORTNICK, M.D., LTD.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309808600
|
Plan sponsor’s
address |
303 E. ARMY TRAIL RD, SUITE 131, BLOOMINGDALE, IL, 60108
|
Signature of
Role |
Plan administrator |
Date |
2013-10-02 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-02 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARY J. BORTNICK, M.D., LTD. CASH BALANCE PENSION PLAN & TRUST
|
2012
|
363431285
|
2013-07-05
|
CARY J. BORTNICK, M.D., LTD.
|
15
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309808600
|
Plan sponsor’s
address |
303 E. ARMY TRAIL RD, SUITE 131, BLOOMINGDALE, IL, 60108
|
Signature of
Role |
Plan administrator |
Date |
2013-07-05 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-05 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARY J. BORTNICK, M.D., LTD. PROFIT SHARING PLAN & TRUST
|
2011
|
363431285
|
2012-09-21
|
CARY J. BORTNICK, M.D., LTD.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309808600
|
Plan sponsor’s
address |
303 E. ARMY TRAIL RD, SUITE 131, BLOOMINGDALE, IL, 60108
|
Plan administrator’s name and address
Administrator’s EIN |
363431285 |
Plan administrator’s name |
CARY J. BORTNICK, M.D., LTD. |
Plan administrator’s
address |
303 E. ARMY TRAIL RD, SUITE 131, BLOOMINGDALE, IL, 60108 |
Administrator’s telephone number |
6309808600 |
Signature of
Role |
Plan administrator |
Date |
2012-09-18 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-09-18 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARY J. BORTNICK, M.D., LTD. CASH BALANCE PENSION PLAN & TRUST
|
2011
|
363431285
|
2012-09-21
|
CARY J. BORTNICK, M.D., LTD.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309808600
|
Plan sponsor’s
address |
303 E. ARMY TRAIL RD, SUITE 131, BLOOMINGDALE, IL, 60108
|
Plan administrator’s name and address
Administrator’s EIN |
363431285 |
Plan administrator’s name |
CARY J. BORTNICK, M.D., LTD. |
Plan administrator’s
address |
303 E. ARMY TRAIL RD, SUITE 131, BLOOMINGDALE, IL, 60108 |
Administrator’s telephone number |
6309808600 |
Signature of
Role |
Plan administrator |
Date |
2012-09-18 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-09-18 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARY J. BORTNICK, M.D., LTD. CASH BALANCE PENSION PLAN & TRUST
|
2010
|
363431285
|
2011-08-29
|
CARY J. BORTNICK, M.D., LTD.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309808600
|
Plan sponsor’s
address |
303 E. ARMY TRAIL RD., SUITE 131, BLOOMINGDALE, IL, 60108
|
Plan administrator’s name and address
Administrator’s EIN |
363431285 |
Plan administrator’s name |
CARY J. BORTNICK, M.D., LTD. |
Plan administrator’s
address |
303 E. ARMY TRAIL RD., SUITE 131, BLOOMINGDALE, IL, 60108 |
Administrator’s telephone number |
6309808600 |
Signature of
Role |
Plan administrator |
Date |
2011-08-29 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-08-29 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARY J. BORTNICK, M.D., LTD. PROFIT SHARING PLAN & TRUST
|
2010
|
363431285
|
2011-08-30
|
CARY J. BORTNICK, M.D., LTD.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309808600
|
Plan sponsor’s
address |
303 E. ARMY TRAIL RD., SUITE 131, BLOOMINGDALE, IL, 60108
|
Plan administrator’s name and address
Administrator’s EIN |
363431285 |
Plan administrator’s name |
CARY J. BORTNICK, M.D., LTD. |
Plan administrator’s
address |
303 E. ARMY TRAIL RD., SUITE 131, BLOOMINGDALE, IL, 60108 |
Administrator’s telephone number |
6309808600 |
Signature of
Role |
Plan administrator |
Date |
2011-08-30 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-08-30 |
Name of individual signing |
CARY BORTNICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARY J. BORTNICK, M.D., LTD. PROFIT SHARING PLAN & TRUST
|
2009
|
363431285
|
2010-10-15
|
CARY J. BORTNICK, M.D., LTD.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1987-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309808600
|
Plan sponsor’s
address |
303 E. ARMY TRAIL RD., SUITE 131, BLOOMINGDALE, IL, 60108
|
Plan administrator’s name and address
Administrator’s EIN |
363431285 |
Plan administrator’s name |
CARY J. BORTNICK, M.D., LTD. |
Plan administrator’s
address |
303 E. ARMY TRAIL RD., SUITE 131, BLOOMINGDALE, IL, 60108 |
Administrator’s telephone number |
6309808600 |
Signature of
Role |
Plan administrator |
Date |
2010-10-15 |
Name of individual signing |
CARY J BORTNICK, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-15 |
Name of individual signing |
CARY J BORTNICK, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CARY J. BORTNICK, M.D., LTD. CASH BALANCE PENSION PLAN & TRUST
|
2009
|
363431285
|
2010-10-15
|
CARY J. BORTNICK, M.D., LTD.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309808600
|
Plan sponsor’s
address |
303 E. ARMY TRAIL RD., SUITE 131, BLOOMINGDALE, IL, 60108
|
Plan administrator’s name and address
Administrator’s EIN |
363431285 |
Plan administrator’s name |
CARY J. BORTNICK, M.D., LTD. |
Plan administrator’s
address |
303 E. ARMY TRAIL RD., SUITE 131, BLOOMINGDALE, IL, 60108 |
Administrator’s telephone number |
6309808600 |
Signature of
Role |
Plan administrator |
Date |
2010-10-15 |
Name of individual signing |
CARY J BORTNICK MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-15 |
Name of individual signing |
CARY J BORTNICK MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|