NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST
|
2014
|
363853769
|
2015-07-16
|
NADEEM ANSARI M.D. S.C.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159291191
|
Plan sponsor’s
address |
400 RIVERSIDE DRIVE, SUITE 1600, BOURBONNAIS, IL, 60914
|
Signature of
Role |
Plan administrator |
Date |
2015-07-16 |
Name of individual signing |
NADEEM ANSARI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST
|
2013
|
363853769
|
2014-07-31
|
NADEEM ANSARI M.D. S.C.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159291191
|
Plan sponsor’s
address |
400 RIVERSIDE DRIVE, SUITE 1600, BOURBONNAIS, IL, 60914
|
Signature of
Role |
Plan administrator |
Date |
2014-07-31 |
Name of individual signing |
NADEEM ANSARI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST
|
2012
|
363853769
|
2013-10-04
|
NADEEM ANSARI M.D. S.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159291191
|
Plan sponsor’s
address |
400 RIVERSIDE DRIVE, SUITE 1600, BOURBONNAIS, IL, 60914
|
Signature of
Role |
Plan administrator |
Date |
2013-10-04 |
Name of individual signing |
NADEEM ANSARI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST
|
2011
|
363853769
|
2012-10-11
|
NADEEM ANSARI M.D. S.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159374404
|
Plan sponsor’s
address |
401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901
|
Plan administrator’s name and address
Administrator’s EIN |
363853769 |
Plan administrator’s name |
NADEEM ANSARI M.D. S.C. |
Plan administrator’s
address |
401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901 |
Administrator’s telephone number |
8159374404 |
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
NADEEM ANSARI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST
|
2010
|
363853769
|
2011-10-14
|
NADEEM ANSARI M.D. S.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159374404
|
Plan sponsor’s
address |
401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901
|
Plan administrator’s name and address
Administrator’s EIN |
363853769 |
Plan administrator’s name |
NADEEM ANSARI M.D. S.C. |
Plan administrator’s
address |
401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901 |
Administrator’s telephone number |
8159374404 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
NADEEM ANSARI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NADEEM ANSARI M.D. S.C. EMPLOYEES PROFIT SHARING AND SAVINGS PLAN & TRUST
|
2009
|
363853769
|
2010-10-15
|
NADEEM ANSARI M.D. S.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159374404
|
Plan sponsor’s
address |
401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901
|
Plan administrator’s name and address
Administrator’s EIN |
363853769 |
Plan administrator’s name |
NADEEM ANSARI M.D. S.C. |
Plan administrator’s
address |
401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901 |
Administrator’s telephone number |
8159374404 |
|
NADEEM ANSARI M.D. S.C. EMPLOYEES PROFIT SHARING AND SAVINGS PLAN & TRUST
|
2009
|
363853769
|
2010-10-15
|
NADEEM ANSARI M.D. S.C.
|
7
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159374404
|
Plan sponsor’s
address |
401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901
|
Plan administrator’s name and address
Administrator’s EIN |
363853769 |
Plan administrator’s name |
NADEEM ANSARI M.D. S.C. |
Plan administrator’s
address |
401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901 |
Administrator’s telephone number |
8159374404 |
Signature of
Role |
Plan administrator |
Date |
2010-10-15 |
Name of individual signing |
PAMELA MAHLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|