|
BLACKJACK EXPRESS INC. 401(K) PROFIT SHARING & TRUST
|
2022
|
364002798
|
2024-12-09
|
BLACKJACK EXPRESS INC.
|
17
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
488510
|
| Sponsor’s telephone number |
8474380242
|
| Plan sponsor’s
address |
200 N FAIRWAY DR STE 182, VERNON HILLS, IL, 600611861
|
Signature of
| Role |
Plan administrator |
| Date |
2024-12-09 |
| Name of individual signing |
JOEL PLOTSKY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2024-12-09 |
| Name of individual signing |
JOEL PLOTSKY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BLACKJACK EXPRESS INC 401(K) PROFIT SHARING PLAN & TRUST
|
2021
|
364002798
|
2022-06-11
|
BLACKJACK EXPRESS INC
|
15
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
488510
|
| Sponsor’s telephone number |
8474380242
|
| Plan sponsor’s
address |
200 NORTH FAIRWAY DRIVE SUITE 182-1, VERNON HILLS, IL, 60061
|
Plan administrator’s name and address
| Administrator’s EIN |
471637791 |
| Plan administrator’s name |
ERISA FIDUCIARY SERVICES, INC. |
| Plan administrator’s
address |
1373 VETERANS HIGHWAY, SUITE 10, HAUPPAUGE, NY, 11788 |
| Administrator’s telephone number |
6312490500 |
Signature of
| Role |
Plan administrator |
| Date |
2022-06-11 |
| Name of individual signing |
ERISA FIDUCIARY SERVICES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BLACKJACK EXPRESS INC 401(K) PROFIT SHARING PLAN & TRUST
|
2020
|
364002798
|
2021-04-01
|
BLACKJACK EXPRESS INC
|
14
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
488510
|
| Sponsor’s telephone number |
8474380242
|
| Plan sponsor’s
address |
200 NORTH FAIRWAY DRIVE SUITE 182-1, VERNON HILLS, IL, 60061
|
Signature of
| Role |
Plan administrator |
| Date |
2021-04-01 |
| Name of individual signing |
ERISA FIDUCIARY SERVICES |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
