|
SAJJAN K. NEMANI, M.D., S.C. EMPLOYEE SAVINGS PLAN
|
2011
|
371377731
|
2012-10-15
|
SAJJAN K. NEMANI, M.D., S.C.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6185338700
|
| Plan sponsor’s
address |
1054 MARTIN LUTHER KING DRIVE, SUITE 124, CENTRALIA, IL, 62801
|
Plan administrator’s name and address
| Administrator’s EIN |
371377731 |
| Plan administrator’s name |
SAJJAN K. NEMANI, M.D., S.C. |
| Plan administrator’s
address |
1054 MARTIN LUTHER KING DRIVE, SUITE 124, CENTRALIA, IL, 62801 |
| Administrator’s telephone number |
6185338700 |
Signature of
| Role |
Plan administrator |
| Date |
2012-10-15 |
| Name of individual signing |
SAJJAN K NEMANI |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
|
SAJJAN K. NEMANI, M.D., S.C., PENSION PLAN AND TRUST
|
2011
|
371377731
|
2012-10-15
|
SAJJAN K. NEMANI, M.D., S.C.
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2011-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6185338700
|
| Plan sponsor’s
address |
1054 MARTIN LUTHER KING DRIVE, SUITE 124, CENTRALIA, IL, 62801
|
Plan administrator’s name and address
| Administrator’s EIN |
371377731 |
| Plan administrator’s name |
SAJJAN K. NEMANI, M.D., S.C. |
| Plan administrator’s
address |
1054 MARTIN LUTHER KING DRIVE, SUITE 124, CENTRALIA, IL, 62801 |
| Administrator’s telephone number |
6185338700 |
Signature of
| Role |
Plan administrator |
| Date |
2012-10-15 |
| Name of individual signing |
SAJJAN K NEMANI |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
|
SAJJAN K. NEMANI, M.D., S.C. EMPLOYEE SAVINGS PLAN
|
2011
|
371377731
|
2012-10-15
|
SAJJAN K. NEMANI, M.D., S.C.
|
10
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2011-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6185338700
|
| Plan sponsor’s
address |
1054 MARTIN LUTHER KING DRIVE, SUITE 154, CENTRALIA, IL, 62801
|
Plan administrator’s name and address
| Administrator’s EIN |
371377731 |
| Plan administrator’s name |
SAJJAN K. NEMANI, M.D., S.C. |
| Plan administrator’s
address |
1054 MARTIN LUTHER KING DRIVE, SUITE 154, CENTRALIA, IL, 62801 |
| Administrator’s telephone number |
6185338700 |
Signature of
| Role |
Plan administrator |
| Date |
2012-10-13 |
| Name of individual signing |
SAJJAN K NEMANI MD |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
