PRAFULLA K. KONERU, M.D., S.C. PROFIT SHARING PLAN AND TRUST
|
2013
|
363711920
|
2014-06-08
|
PRAFULLA K. KONERU, M.D., S.C.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8473828200
|
Plan sponsor’s
address |
5 EXECUTIVE COURT, SUITE # 1, SOUTH BARRINGTON, IL, 60010
|
Signature of
Role |
Plan administrator |
Date |
2014-06-08 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-06-08 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAFULLA K. KONERU, M.D., S.C. PROFIT SHARING PLAN AND TRUST
|
2012
|
363711920
|
2013-10-02
|
PRAFULLA K. KONERU, M.D., S.C.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8473828200
|
Plan sponsor’s
address |
5 EXECUTIVE COURT, SUITE # 1, SOUTH BARRINGTON, IL, 60010
|
Signature of
Role |
Plan administrator |
Date |
2013-10-02 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-02 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAFULLA K. KONERU, M.D., S.C. PROFIT SHARING PLAN AND TRUST
|
2011
|
363711920
|
2012-10-11
|
PRAFULLA K. KONERU, M.D., S.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8473828200
|
Plan sponsor’s
address |
5 EXECUTIVE COURT, SUITE # 1, SOUTH BARRINGTON, IL, 60010
|
Plan administrator’s name and address
Administrator’s EIN |
363711920 |
Plan administrator’s name |
PRAFULLA K. KONERU, M.D., S.C. |
Plan administrator’s
address |
5 EXECUTIVE COURT, SUITE # 1, SOUTH BARRINGTON, IL, 60010 |
Administrator’s telephone number |
8473828200 |
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-11 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAFULLA K. KONERU, M.D., S.C. PROFIT SHARING PLAN AND TRUST
|
2010
|
363711920
|
2011-10-13
|
PRAFULLA K. KONERU, M.D., S.C.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8473828200
|
Plan sponsor’s
address |
5 EXECUTIVE COURT, SUITE #1, SOUTH BARRINGTON, IL, 60010
|
Plan administrator’s name and address
Administrator’s EIN |
363711920 |
Plan administrator’s name |
PRAFULLA K. KONERU, M.D., S.C. |
Plan administrator’s
address |
5 EXECUTIVE COURT, SUITE #1, SOUTH BARRINGTON, IL, 60010 |
Administrator’s telephone number |
8473828200 |
Signature of
Role |
Plan administrator |
Date |
2011-10-13 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-10-13 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAFULLA K. KONERU, M.D., S.C. PROF SHAR PLN AND TRUST
|
2009
|
363711920
|
2010-10-14
|
PRAFULLA K. KONERU, M.D., S.C.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8478852444
|
Plan sponsor’s
address |
1555 N. BARRINGTON ROAD, SUITE 540, HOFFMAN ESTATES, IL, 601691098
|
Plan administrator’s name and address
Administrator’s EIN |
363711920 |
Plan administrator’s name |
PRAFULLA K. KONERU, M.D., S.C. |
Plan administrator’s
address |
1555 N. BARRINGTON ROAD, SUITE 540, HOFFMAN ESTATES, IL, 601691098 |
Administrator’s telephone number |
8478852444 |
Signature of
Role |
Plan administrator |
Date |
2010-10-14 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-14 |
Name of individual signing |
PRAFULLA KONERU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|