LYNN MERSHON, D.O., LTD. 401(K) PROFIT SHARING PLAN & TRUST
|
2014
|
364120810
|
2015-10-12
|
LYNN MERSHON, D.O., LTD.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472895727
|
Plan sponsor’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123
|
Signature of
Role |
Plan administrator |
Date |
2015-10-11 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-11 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LYNN MERSHON, D.O., LTD. 401(K) PROFIT SHARING PLAN & TRUST
|
2014
|
364120810
|
2015-10-12
|
LYNN MERSHON, D.O., LTD.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472895757
|
Plan sponsor’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123
|
Signature of
Role |
Plan administrator |
Date |
2015-10-11 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-11 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LYNN MERSHON, D.O., LTD. 401(K) PROFIT SHARING PLAN & TRUST
|
2013
|
364120810
|
2015-06-17
|
LYNN MERSHON, D.O., LTD.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472895757
|
Plan sponsor’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123
|
Signature of
Role |
Plan administrator |
Date |
2015-06-16 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-06-16 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LYNN MERSHON, D.O., LTD. 401(K) PROFIT SHARING PLAN & TRUST
|
2012
|
364120810
|
2013-10-17
|
LYNN MERSHON, D.O., LTD.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472895757
|
Plan sponsor’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123
|
Signature of
Role |
Plan administrator |
Date |
2013-10-17 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-17 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LYNN MERSHON, D.O., LTD. 401(K) PROFIT SHARING PLAN & TRUST
|
2011
|
364120810
|
2012-09-07
|
LYNN MERSHON, D.O., LTD.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472895757
|
Plan sponsor’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123
|
Plan administrator’s name and address
Administrator’s EIN |
364120810 |
Plan administrator’s name |
LYNN MERSHON, D.O., LTD. |
Plan administrator’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123 |
Administrator’s telephone number |
8472895757 |
Signature of
Role |
Plan administrator |
Date |
2012-09-05 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-09-05 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LYNN MERSHON, D.O., LTD. 401(K) PROFIT SHARING PLAN & TRUST
|
2010
|
364120810
|
2011-10-13
|
LYNN MERSHON, D.O., LTD.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472895727
|
Plan sponsor’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123
|
Plan administrator’s name and address
Administrator’s EIN |
364120810 |
Plan administrator’s name |
LYNN MERSHON, D.O., LTD. |
Plan administrator’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123 |
Administrator’s telephone number |
8472895727 |
Signature of
Role |
Plan administrator |
Date |
2011-10-13 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-10-13 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LYNN MERSHON, D.O., LTD. CASH BALANCE PENSION PLAN
|
2010
|
364120810
|
2011-01-17
|
LYNN MERSHON, D.O., LTD
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8472895757
|
Plan sponsor’s
address |
1990 LARKIN AVE, SUITE 3, SUITE G, ELGIN, IL, 60123
|
Plan administrator’s name and address
Administrator’s EIN |
364120810 |
Plan administrator’s name |
LYNN MERSHON, D.O., LTD |
Plan administrator’s
address |
1990 LARKIN AVE, SUITE 3, SUITE G, ELGIN, IL, 60123 |
Administrator’s telephone number |
8472895757 |
Signature of
Role |
Plan administrator |
Date |
2011-01-16 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-16 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LYNN MERSHON, D.O., LTD. 401(K) PROFIT SHARING PLAN & TRUST
|
2009
|
364120810
|
2010-07-30
|
LYNN MERSHON, D.O., LTD.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8472895727
|
Plan sponsor’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123
|
Plan administrator’s name and address
Administrator’s EIN |
364120810 |
Plan administrator’s name |
LYNN MERSHON, D.O., LTD. |
Plan administrator’s
address |
1990 LARKIN AVENUE, SUITE 3, ELGIN, IL, 60123 |
Administrator’s telephone number |
8472895727 |
Signature of
Role |
Plan administrator |
Date |
2010-07-29 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-29 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LYNN MERSHON, D.O., LTD. CASH BALANCE PENSION PLAN
|
2009
|
364120810
|
2010-07-30
|
LYNN MERSHON, D.O., LTD
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8472895757
|
Plan sponsor’s
address |
1990 LARKIN AVE, SUITE 3, SUITE G, ELGIN, IL, 60123
|
Plan administrator’s name and address
Administrator’s EIN |
364120810 |
Plan administrator’s name |
LYNN MERSHON, D.O., LTD |
Plan administrator’s
address |
1990 LARKIN AVE, SUITE 3, SUITE G, ELGIN, IL, 60123 |
Administrator’s telephone number |
8472895757 |
Signature of
Role |
Plan administrator |
Date |
2010-07-29 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-29 |
Name of individual signing |
LYNN MERSHON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|