|
JEFFREY S. WAITZMAN, M.D., S.C. EMPLOYEES' PROFIT SHARING PLAN & TRUST
|
2011
|
363463288
|
2012-08-01
|
JEFFREY S. WAITZMAN, M.D., S.C.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1987-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8477191300
|
| Plan sponsor’s
address |
183 OAKMONT DRIVE, DEERFIELD, IL, 60015
|
Plan administrator’s name and address
| Administrator’s EIN |
363463288 |
| Plan administrator’s name |
JEFFREY S. WAITZMAN, M.D., S.C. |
| Plan administrator’s
address |
183 OAKMONT DRIVE, DEERFIELD, IL, 60015 |
| Administrator’s telephone number |
8477191300 |
Signature of
| Role |
Plan administrator |
| Date |
2012-08-01 |
| Name of individual signing |
JEFFREY S. WAITZMAN, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JEFFREY S. WAITZMAN, M.D., S.C. EMPLOYEES' PROFIT SHARING PLAN & TRUST
|
2010
|
363463288
|
2011-06-16
|
JEFFREY S. WAITZMAN, M.D., S.C.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1987-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8477191300
|
| Plan sponsor’s
address |
C/O LAW OFFICES OF GARY R. WAITZMAN, 250 PARKWAY DRIVE, SUITE 130, LINCOLNSHIRE, IL, 60069
|
Plan administrator’s name and address
| Administrator’s EIN |
363463288 |
| Plan administrator’s name |
JEFFREY S. WAITZMAN, M.D., S.C. |
| Plan administrator’s
address |
C/O LAW OFFICES OF GARY R. WAITZMAN, 250 PARKWAY DRIVE, SUITE 130, LINCOLNSHIRE, IL, 60069 |
| Administrator’s telephone number |
8477191300 |
Signature of
| Role |
Plan administrator |
| Date |
2011-06-16 |
| Name of individual signing |
JEFFREY S. WAITZMAN, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JEFFREY S. WAITZMAN, M.D., S.C. EMPLOYEES' PROFIT SHARING PLAN & TRUST
|
2009
|
363463288
|
2010-09-30
|
JEFFREY S. WAITZMAN, M.D., S.C.
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1987-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8476980400
|
| Plan sponsor’s
address |
1875 DEMPSTER STREET, SUITE 265, PARK RIDGE, IL, 60068
|
Plan administrator’s name and address
| Administrator’s EIN |
363463288 |
| Plan administrator’s name |
JEFFREY S. WAITZMAN, M.D., S.C. |
| Plan administrator’s
address |
1875 DEMPSTER STREET, SUITE 265, PARK RIDGE, IL, 60068 |
| Administrator’s telephone number |
8476980400 |
Signature of
| Role |
Plan administrator |
| Date |
2010-09-30 |
| Name of individual signing |
JEFFREY S. WAITZMAN, M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
