ELK GROVE LAB PHYSICIANS, P.C. CASH BALANCE PENSION PLAN
|
2010
|
363775529
|
2011-07-12
|
ELK GROVE LAB PHYSICIANS, P.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2007-01-01
|
Business code |
621510
|
Sponsor’s telephone number |
8475097331
|
Plan sponsor’s
address |
C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 400, NORTHBROOK, IL, 60062
|
Plan administrator’s name and address
Administrator’s EIN |
363775529 |
Plan administrator’s name |
ELK GROVE LAB PHYSICIANS, P.C. |
Plan administrator’s
address |
5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062 |
Administrator’s telephone number |
8475097331 |
Signature of
Role |
Plan administrator |
Date |
2011-07-12 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-12 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ELK GROVE LAB PHYSICIANS, P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2010
|
363775529
|
2011-07-13
|
ELK GROVE LAB PHYSICIANS, P.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2000-01-01
|
Business code |
621510
|
Sponsor’s telephone number |
8475097331
|
Plan sponsor’s
address |
C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062
|
Plan administrator’s name and address
Administrator’s EIN |
363775529 |
Plan administrator’s name |
ELK GROVE LAB PHYSICIANS, P.C. |
Plan administrator’s
address |
C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062 |
Administrator’s telephone number |
8475097331 |
Signature of
Role |
Plan administrator |
Date |
2011-07-13 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-13 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ELK GROVE LAB PHYSICIANS, P.C. CASH BALANCE PENSION PLAN
|
2009
|
363775529
|
2010-09-28
|
ELK GROVE LAB PHYSICIANS, P.C.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2007-01-01
|
Business code |
621510
|
Sponsor’s telephone number |
8475097331
|
Plan sponsor’s
address |
C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062
|
Plan administrator’s name and address
Administrator’s EIN |
363775529 |
Plan administrator’s name |
ELK GROVE LAB PHYSICIANS, P.C. |
Plan administrator’s
address |
5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062 |
Administrator’s telephone number |
8475097331 |
Signature of
Role |
Plan administrator |
Date |
2010-09-28 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-09-28 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ELK GROVE LAB PHYSICIANS, P.C. CASH BALANCE PENSION PLAN
|
2009
|
363775529
|
2010-09-28
|
ELK GROVE LAB PHYSICIANS, P.C.
|
4
|
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2007-01-01
|
Business code |
621510
|
Sponsor’s telephone number |
8475097331
|
Plan sponsor’s
address |
C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062
|
Plan administrator’s name and address
Administrator’s EIN |
363775529 |
Plan administrator’s name |
ELK GROVE LAB PHYSICIANS, P.C. |
Plan administrator’s
address |
5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062 |
Administrator’s telephone number |
8475097331 |
Signature of
Role |
Plan administrator |
Date |
2010-09-28 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-09-28 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ELK GROVE LAB PHYSICIANS, P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2009
|
363775529
|
2010-09-27
|
ELK GROVE LAB PHYSICIANS, P.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2000-01-01
|
Business code |
621510
|
Sponsor’s telephone number |
8475097331
|
Plan sponsor’s
address |
C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062
|
Plan administrator’s name and address
Administrator’s EIN |
363775529 |
Plan administrator’s name |
ELK GROVE LAB PHYSICIANS, P.C. |
Plan administrator’s
address |
C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062 |
Administrator’s telephone number |
8475097331 |
Signature of
Role |
Plan administrator |
Date |
2010-09-27 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-09-27 |
Name of individual signing |
CARLOS SHIBATA, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|