OMNITELESYS, INC.

Company Details

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

JACKSON SUPERMARKETS, INC. RETIREMENT SAVINGS PLAN

2010

371263746

2011-09-06

JACKSON SUPERMARKETS, INC.

Plan administrator’s name and address

Administrator’s EIN	371263746
Plan administrator’s name	JACKSON SUPERMARKETS, INC.
Plan administrator’s address	302 N CENTER ST, CLINTON, IL, 617271402
Administrator’s telephone number	2179355459

Signature of

Role	Plan administrator
Date	2011-09-06
Name of individual signing	DAVID JACKSON
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2011-09-06
Name of individual signing	DAVID JACKSON
Valid signature	Filed with authorized/valid electronic signature

JACKSON SUPERMARKETS, INC. RETIREMENT SAVINGS PLAN

2009

371263746

2011-09-12

JACKSON SUPERMARKETS, INC.

Plan administrator’s name and address

Administrator’s EIN	371263746
Plan administrator’s name	JACKSON SUPERMARKETS, INC.
Plan administrator’s address	302 N CENTER ST, CLINTON, IL, 617271402
Administrator’s telephone number	2179355459

Signature of

Role	Plan administrator
Date	2011-09-12
Name of individual signing	DAVID JACKSON
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2011-09-12
Name of individual signing	DAVID JACKSON
Valid signature	Filed with authorized/valid electronic signature

Name and Address	Role	Appointment Date
MARNA SMELTZER, 2860 S RIVER ROAD #390, DES PLAINES, 60018, COOK-NOT IN CITY OF CHICAGO	Agent	1994-01-14

Name and Address	Role
JOHN N CURAYTER, 2860 RIVER RD DES PLAINES 60018	President

Class	Series	Voting Rights	Authorized Shares	Issued Shares	Par Value
COMM	No data	Voting Rights	1000000	100000	1

Date of last update: 16 Jan 2025