ART OF DENTISTRY, P.C. DBA DELAWARE DENTAL PENSION PLAN
|
2010
|
364068799
|
2011-07-28
|
ART OF DENTISTRY, P.C.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3127879555
|
Plan sponsor’s
address |
1 EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611
|
Plan administrator’s name and address
Administrator’s EIN |
364068799 |
Plan administrator’s name |
ART OF DENTISTRY, P.C. |
Plan administrator’s
address |
1 EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611 |
Administrator’s telephone number |
3127879555 |
Signature of
Role |
Plan administrator |
Date |
2011-07-28 |
Name of individual signing |
DAVID SCHEFFLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ART OF DENTISTRY, P.C. DBA DELAWARE DENTAL PENSION PLAN
|
2009
|
364068799
|
2010-10-14
|
ART OF DENTISTRY, P.C.
|
4
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3127879555
|
Plan
sponsor’s DBA name |
DELAWARE DENTAL
|
Plan sponsor’s
address |
ONE EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611
|
Plan administrator’s name and address
Administrator’s EIN |
364068799 |
Plan administrator’s name |
ART OF DENTISTRY, P.C. |
Plan administrator’s
address |
ONE EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611 |
Administrator’s telephone number |
3127879555 |
Signature of
Role |
Plan administrator |
Date |
2010-10-14 |
Name of individual signing |
DAVID SCHEFFLER |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-14 |
Name of individual signing |
DAVID SCHEFFLER |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
ART OF DENTISTRY, P.C. DBA DELAWARE DENTAL PENSION PLAN
|
2009
|
364068799
|
2010-10-14
|
ART OF DENTISTRY, P.C.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3127879555
|
Plan
sponsor’s DBA name |
DELAWARE DENTAL
|
Plan sponsor’s
address |
ONE EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611
|
Plan administrator’s name and address
Administrator’s EIN |
364068799 |
Plan administrator’s name |
ART OF DENTISTRY, P.C. |
Plan administrator’s
address |
ONE EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611 |
Administrator’s telephone number |
3127879555 |
Signature of
Role |
Plan administrator |
Date |
2010-10-14 |
Name of individual signing |
DAVID SCHEFFLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-14 |
Name of individual signing |
DAVID SCHEFFLER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ART OF DENTISTRY, P.C. DBA DELAWARE DENTAL PENSION PLAN
|
2009
|
364068799
|
2010-10-14
|
ART OF DENTISTRY, P.C.
|
4
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3127879555
|
Plan
sponsor’s DBA name |
DELAWARE DENTAL
|
Plan sponsor’s
address |
ONE EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611
|
Plan administrator’s name and address
Administrator’s EIN |
364068799 |
Plan administrator’s name |
ART OF DENTISTRY, P.C. |
Plan administrator’s
address |
ONE EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611 |
Administrator’s telephone number |
3127879555 |
Signature of
Role |
Plan administrator |
Date |
2010-10-14 |
Name of individual signing |
DAVID SCHEFFLER |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-14 |
Name of individual signing |
DAVID SCHEFFLER |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
ART OF DENTISTRY, P.C. DBA DELAWARE DENTAL PENSION PLAN
|
2009
|
364068799
|
2010-10-14
|
ART OF DENTISTRY, P.C.
|
4
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
3127879555
|
Plan
sponsor’s DBA name |
DELAWARE DENTAL
|
Plan sponsor’s
address |
ONE EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611
|
Plan administrator’s name and address
Administrator’s EIN |
364068799 |
Plan administrator’s name |
ART OF DENTISTRY, P.C. |
Plan administrator’s
address |
ONE EAST DELAWARE PLACE, SUITE 205, CHICAGO, IL, 60611 |
Administrator’s telephone number |
3127879555 |
Signature of
Role |
Plan administrator |
Date |
2010-10-14 |
Name of individual signing |
DAVID SCHEFFLER |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-14 |
Name of individual signing |
DAVID SCHEFFLER |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|